Septic arthritis of the temporomandibular joint successfully treated with arthroscopic lysis and lavage: case report and review of the literature.
Septic arthritis of the temporomandibular joint (TMJ) is infrequently reported. We present a case of septic arthritis of the TMJ following the extraction of the left upper second molar that occurred 1 week before beginning of symptoms. No evident predisposing factors were detected. Arthroscopic diagnosis of septic arthritis, lysis and lavage, and capsular stretch were performed. Cultures taken from the TMJ space grew Streptococcus sp. After 1 month of antimicrobial therapy the patient was asymptomatic and mandibular function was normal. Literature related to septic arthritis of TMJ and its treatment was reviewed. Different surgical procedures are available to treat this condition. Arthroscopy should be preferred as initial treatment on account of the possibility of drainage and accurate lavage under direct visualization of joint space, at the same time allowing confirmation of diagnostic hypotheses. Improving joint mobility with lysis of adhesions and capsular stretch in an early stage of disease may be helpful in stopping the fibrosis process.
Sembronio
Salvatore
S
Department of Maxillofacial Surgery, Faculty of Medicine, University of Udine, Udine, Italy. ssembronio@hotmail.com
Albiero
Alberto Maria
AM
Robiony
Massimo
M
Costa
Fabio
F
Toro
Corrado
C
Politi
Massimo
M
D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000209:etiology / Q000382:microbiology / Q000601:surgery*; D001182:Arthroscopy; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D015242:Ofloxacin / Q000627:therapeutic use; D013290:Streptococcal Infections / Q000209:etiology / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000209:etiology / Q000382:microbiology / Q000601:surgery*; D007507:Therapeutic Irrigation; D014081:Tooth Extraction / Q000009:adverse effects
D000900:Anti-Bacterial Agents; D000658:Amoxicillin; D015242:Ofloxacin