2011 Volume 23 Issue 3 Pages 155-160
Suppurative arthritis is a comparatively rare disease. We report a case of suppurative arthritis of the right temporomandibular joint with an abscess in the lateral pterygoid muscle. The patient was a 58-year-old man who complained of swelling of the right temporomandibular joint area and jaw opening pain. There was diffuse swelling and induration in the right temporomandibular joint area. Maximum interincisal opening was 18 mm and lateral open bite of about 2 mm on the right molar region was recognized in the occlusal position. Computed tomography and MRI showed bone resorption at the medial pole of the right mandibular condyle and abscess formation in the right temporomandibular joint capsule and lateral pterygoid muscle. Viscous yellowish-white pus was aspirated through a puncture needle from the abscess. Peptostreptococcus micros, which was resident oral flora, was identified by bacteriological culture. Following treatment with antibiotics, swelling of the right temporomandibular joint area disappeared and maximum interincisal opening increased to 47 mm with a rightward mandibular deviation and joint noise. Since resident oral flora was the offending bacteria of the infection, it was thought that the odontogenic infection had spread to the mandibular condyle and the lateral pterygoid muscle.
