Gams Kevin, Freeman Phillip
Resident, Department of Oral and Maxillofacial Surgery, University of Texas-Houston Health Science Center, Houston, TX.
Associate Professor, Department of Oral and Maxillofacial Surgery, University of Texas-Houston Health Science Center, Houston, TX.
J Oral Maxillofac Surg. 2016 Apr;74(4):754-63. doi: 10.1016/j.joms.2015.11.003. Epub 2015 Nov 6.
Septic arthritis of the temporomandibular joint (TMJ) has been infrequently reported in the literature. Some investigators believe that this condition is under-reported because it is underdiagnosed. Misdiagnosis or late diagnosis of this condition can lead to serious morbidity, including fistula formation, intracranial abscess, fibrous or bony ankylosis, temporal bone or condylar osteomyelitis, growth alteration, and several others. This report describes a case of septic TMJ arthritis arising from direct spread of an odontogenic infection with subsequent development of mandibular osteomyelitis. The purpose of this case report is to 1) increase awareness of an underdiagnosed condition, 2) establish the seriousness of this infection, 3) for the first time report on a case of TMJ septic arthritis caused by Bacteroides infection, and 4) provide a review of the relevant literature.
颞下颌关节(TMJ)的化脓性关节炎在文献中报道较少。一些研究者认为,这种情况报告不足是因为诊断不足。对该疾病的误诊或延迟诊断可导致严重的发病情况,包括瘘管形成、颅内脓肿、纤维性或骨性强直、颞骨或髁突骨髓炎、生长改变等。本报告描述了一例因牙源性感染直接蔓延导致颞下颌关节化脓性关节炎并继发下颌骨骨髓炎的病例。本病例报告的目的是:1)提高对这种诊断不足疾病的认识;2)明确这种感染的严重性;3)首次报告一例由拟杆菌感染引起的颞下颌关节化脓性关节炎病例;4)对相关文献进行综述。