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 successfully treated with arthroscopic lysis and lavage: case report and review of the literature
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DOI：
10.1016/j.tripleo.2006.08.028
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发表时间：
2007-02-01
期刊：
影响因子：
--
通讯作者：
Politit, Massimo
中科院分区：
文献类型：
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作者：
Sembronio, Salvatore;Albiero, Alberto Maria;Politit, Massimo
颞下颌关节（TMJ）脓毒性关节炎的报道很少。我们提出一个脓毒性关节炎的颞下颌关节后提取左上第二磨牙发生1周前开始的症状。未发现明显的诱发因素。关节镜下诊断为化脓性关节炎，进行松解和灌洗以及关节囊拉伸。从颞下颌关节间隙培养生长链球菌。抗菌治疗1个月后，患者无症状，下颌功能正常。本文就化脓性颞下颌关节炎及其治疗的相关文献进行综述。不同的外科手术可用于治疗这种情况。关节镜应首选作为初始治疗，因为在关节间隙直接可视化的情况下，可以进行引流和准确灌洗，同时可以确认诊断假设。在疾病早期通过粘连松解和关节囊伸展来改善关节活动度可能有助于阻止纤维化过程。
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.