Cai Xie-Yi, Yang Chi, Chen Min-Jin, Zhang Shan-Yong, Yun Bai
Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Jan;109(1):24-30. doi: 10.1016/j.tripleo.2009.08.007.
This article reports on 7 patients with septic arthritis of the temporomandibular joint (TMJ) who were managed with arthroscopy between 1998 and 2007. The common symptoms were trismus and pain. A series of imaging studies showed widening of joint space in 1 patient with plain film; MRI demonstrated increased joint effusion in 4 patients; accompanying cellulitis in adjacent tissues was discerned by CT in 2 patients. Under the arthroscope, a reddened and swollen synovial membrane was found in 2 patients who were in the acute stage, whereas strong adhesions, destruction of cartilage, and bony defects were discovered in other 5 patients in the 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. Arthroscopy has proven to be a useful method for management of septic arthritis of TMJ, especially for patients in the chronic stage.
本文报道了1998年至2007年间接受关节镜治疗的7例颞下颌关节（TMJ）化脓性关节炎患者。常见症状为牙关紧闭和疼痛。一系列影像学检查显示，1例患者平片显示关节间隙增宽；4例患者MRI显示关节积液增加；2例患者CT显示相邻组织伴有蜂窝织炎。关节镜下，2例急性期患者滑膜红肿，而其他5例慢性期患者发现有严重粘连、软骨破坏和骨缺损。此外，3例患者盘状软骨破裂，2例患者证实有纤维化。灌洗、粘连松解和关节面清创是常见的治疗方法。平均随访期为57.4个月，未发现复发。关节镜已被证明是治疗TMJ化脓性关节炎的一种有用方法，尤其是对于慢性期患者。
