Septic arthritis of the TMJ: a case report

ABSTRACT Septic arthritis of the temporomandibular joint (TMJ) is an uncommon condition; thus, reports in the specialized literature are still scarce. The TMJ may be affected by extension of a local infectious process, by post-traumatic hematoma, or secondarily, by hematogenous spread. Septic arthritis is more common in the large joints, with the knee and hip most frequently affected. It is characterized by insidious onset and a marked inflammatory process, and is monoarticular in 80% of cases. The present report describes the case of a 6-year-old boy with a history of rheumatoid arthritis who presented with pain, swelling, and redness in the right TMJ region, as well as limited jaw opening, closure, and lateral excursion bilaterally. The differential diagnosis and treatment of this rare clinical entity are described. Aspects concerning antibiotic therapy and imaging studies are also addressed.

摘要 颞下颌关节（Temporomandibular Joint, TMJ）化脓性关节炎是一种少见病症，因此专业文献中的相关报道仍较为匮乏。颞下颌关节可因局部感染灶蔓延、创伤后血肿继发受累，或经由血源性播散而致病。化脓性关节炎更常累及大关节，其中以膝、髋关节受累最为多见。该病以隐匿起病及显著炎症反应为特征，80%的病例表现为单关节受累。本报告描述了1例有类风湿关节炎（rheumatoid arthritis）病史的6岁男童，其临床表现为右侧颞下颌关节区域疼痛、肿胀与发红，同时存在双侧下颌开口、闭口及侧向运动受限。本文对该罕见临床病症的鉴别诊断与治疗进行了阐述，并对抗生素治疗及影像学检查的相关要点进行了探讨。