Septic Arthritis Of Temporomandibular Joint Research Articles

Ultrasound-guided temporomandibular joint aspiration: technique and results in six cases of suspected septic arthritis.

The aim of this study is to describe an ultrasound (US)-guided temporomandibular joint (TMJ) arthrocentesis technique and determine its microbial yield in the workup of suspected TMJ septic arthritis. A retrospective review of US-guided TMJ arthrocentesis for the work-up of septic arthritis performed by radiologists at two institutions was performed. Patient demographics, risk factors for septic arthritis, blood culture results, and pre-procedural imaging findings were recorded. Procedural data included fluid aspirate quantity, needle gauge and length, and any immediate complications. Post-procedural data included synovial fluid analysis including culture, final diagnosis of TMJ disease, type of treatment, and any delayed complications from arthrocentesis. A total of six US-guided TMJ arthrocenteses were identified, all of which yielded at least 1mL of synovial fluid. Five patients were subsequently diagnosed with septic arthritis, and one patient was diagnosed with GVHD arthritis. The synovial fluid in four out of five patients with a final diagnosis of septic arthritis produced positive cultures. There were no immediate or delayed complications from arthrocentesis. Basic US-guided procedural skills are transferrable to TMJ arthrocentesis, which is a low-risk procedure with a high microbial yield in our small series of patients with septic arthritis.

Acute otitis media in an infant complicated with osteoarthritis of temporomandibular joint and sub-periosteal abscess of the clavicle

BackgroundOtomastoiditis is a very frequent affection and a current complication of mal-treated benign ear infections in children. However, this a very rare case of the association of two rare complications of otomastoiditis in a newborn.On the one hand, septic arthritis of the temporomandibular joint which is a very rare condition that is difficult to diagnose, and when unrecognized or not treated accordingly, it can resolve in serious infectious complication and or definitive injury to the temporomandibular joint.On the other hand, osteomyelitis of the clavicle is also very rare, and only a few cases have been cited in the literature concerning infants.Case presentationThis 46-day-old infant was brought to pediatric emergency consultation for 2 swelling inflammatory bulges, one in the right mastoid and pre-auricular regions, and another in the right basi-cervical area. The infant was hypertrophic febrile, hypotonic, and pale. He had preserved archaic reflexes. Besides, blood test showed an inflammatory syndrome, inflammatory anemia, and no other abnormalities.Upon supplementary computed tomodensitometry exam, the diagnosis of a combination of septic arthritis of the right temporomandibular joint and sub-periosteal abscess of the ipsilateral clavicle in a context of hypotrophy and malnutrition was suspected. A pus sample was obtained for bacteriological evaluation, after which the infant had a course of intravenous associated antibiotics, along with nutritional assessment and management. Surgical drainage of both collections was performed. The 6-month follow-up was satisfactory, without clinical signs of functional impact on temporomandibular joint, or acromioclavicular joint.ConclusionThis work stresses the necessity of thorough clinical examination of infants even in cases of benign ear infections, as well as the importance of adapted treatment and follow-up, which could allow early diagnosis, appropriate treatment, or even prevention of severe complications that can be associated with such benign conditions.

Septic Arthritis of the Temporomandibular Joint without an Apparent Source of Infection: A Case Report

Septic arthritis of the temporomandibular joint (TMJ) is a rare disease that is characterized by preauricular pain, edema, malocclusion, trismus and abscess formation in the TMJ region. An 85-year-old male visited our hospital with the complaint of left-sided TMJ swelling, pain and trismus. Septic arthritis of the left TMJ was diagnosed on the basis of considerable elevation of CRP (Creactive proteins) and CT imaging findings. The patient was treated with oral Faropenem at 450 mg daily, but CRP increased three days after the initial visit. He was hospitalized and treated with intravenous administration of cefazolin at 2 g and clindamycin at 1.2 g daily for six days. Propionibacterium species and Veillonella species grew in a culture of the joint aspirate, but there was no apparent source of infection. After acute infectious symptoms had passed, the patient was treated with oral amoxicillin at 750 mg daily for eight weeks and was instructed to do jaw opening exercise. The patient was discharged on the 11th hospital day. After three weeks of the hospital discharge, the patient healed completely. To avoid serious complications, clinicians should include septic arthritis of the TMJ in the differential diagnosis of preauricular pain, trismus and swelling.

Septic arthritis of temporomandibular joint: a rare case report

Septic arthritis of temporomandibular joint: a rare case report

Distraction Osteogenesis as a Treatment for Retrognathia and Obstructive Sleep Apnea Resulting From Temporomandibular Joint Septic Arthritis: A Case Report

Septic arthritis is a rare but serious infective process that is characterized by pain, swelling, and possible loss of function of the affected joint. Knees and hips are the most commonly affected joints, but the temporomandibular joint (TMJ) is among the other joints that are infrequently affected. Reports of septic arthritis of the TMJ are relatively rare, with only approximately 80 cases reported in the previous 70 years.1-10 Of these cases, most have been in adults, with only 11 cases reported in children younger than 12 years.

Septic arthritis of temporomandibular joint treated with arthroscopy

PURPOSE: To summarize the findings of imaging studies and arthroscopy in patients with septic arthritis of temporomandibular joint who were managed with arthroscopy,and to recommend the operative procedures for acute and chronic stage.METHODS: Seven patients were included in this study.Their demographics,predisposing factors,clinical manifestation,imaging findings,joint aspiration,joint fluid culture,arthroscopic findings,treatments,and outcomes were collected and analyzed.RESULTS: The common symptoms were trismus and pain.Series of imaging studies showed widening of joint space in 1 patient with plain film;MRI demonstrated increased joint effusion in 4 patients;accompanied cellulitis in adjacent tissues was discerned by CT in 2 patients;under arthroscope,the reddened and swollen synovial membrane was found in 2 patients who were in acute stage,while severe adhesions,destruction of cartilage and bony defects were discovered in other 5 patients in chronic stage.Additionally,the disc was ruptured in 3 patients,and fibrosis was confirmed for 2 patients.Lavage,lysis of adhesion and debridement of articular surface were common procedures for treatments.The average follow-up period was 57.4 months,and no recurrence was found.CONCLUSION: Arthroscopy is proved to be a useful method for management of septic arthritis of TMJ,especially for the patients in chronic stage.

Mandibular Condylectomy and Meniscectomy for the Treatment of Septic Temporomandibular Joint Arthritis in a Horse

To report use of mandibular condylectomy for treatment of advanced degenerative joint disease of the temporomandibular joint (TMJ) caused by sepsis. Clinical case report. Two-year-old Noriker filly. Computed tomography (CT) was used to confirm advanced degenerative joint disease of the left TMJ and for follow-up after mandibular condylectomy and removal of necrotic meniscus. Painful swelling (3 weeks duration) with drainage located just caudal to the left lateral canthus of the eye was associated with atrophy of the left masseter muscle, masticatory problems, and inappetence. There was incisor malocclusion with a 1.4 cm resting lateral mandibular deviation to the right and inability to open the mouth more than a few centimeters. Left mandibular condylectomy combined with meniscectomy and thorough debridement of the septic left TMJ resulted in resolution of clinical signs and complete return of function. Streptococcus zooepidemicus, intermediately resistant to penicillin and subsequently to enrofloxacin, was isolated from the wound. Regeneration of a mandibular "pseudocondyle" was evident on CT at 4 months. At 4 months and 1 year the filly had maximal mouth opening >10 cm and no malocclusion. Mandibular condylectomy can be used to facilitate management of septic TMJ arthritis. There was no radiologic or clinical evidence of TMJ ankylosis >1 year after meniscal removal. Mandibular condylectomy, including meniscectomy, is an acceptable treatment option for advanced TMJ septic arthritis and allowed return of normal masticatory function.

Streptococcal infection of the temporomandibular joint of hematogenous origin: A case report and contemporary therapy

J Oral Maxillofac Surg 60:1347-1353, 2002

Septic arthritis of the temporomandibular joint: Review of the literature and report of two cases in children

Septic arthritis of the temporomandibular joint (TMJ) has a high morbidity, is infrequently reported, and has been described almost exclusively in adults. We present two cases of septic arthritis of the TMJ that occurred in children after minor blunt trauma. Literature related to septic arthritis of the TMJ was reviewed, and a composite list of cases was constructed. The most common causes were various infections of the head and neck, rheumatic joint disease, and iatrogenesis. Pathogens may gain access to the TMJ by several routes. Patients typically present with an acute, tender, monarticular arthritis with associated swelling and erythema. Malaise, nausea, and vomiting may also be present. Traumatic effusions, fractures, and neoplasms may present in a similar fashion, and mimic TMJ septic arthritis. Staphylococcus aureus is the most commonly reported pathogen and often causes permanent joint damage. Aspiration and analysis of joint fluid, as well as blood chemistry, imaging studies, and clinical impression, may assist in the diagnosis. Timely diagnosis and treatment are essential for a successful outcome; therapy should include antimicrobial agents, adequate drainage, and resting of the joint. Complications include spread of infection, postinfectious bony changes, and fibrous (or bony) ankylosis of the temporomandibular joint.