2011 Volume 57 Issue 11 Pages 596-600
Acute suppurative arthritis of the temporomandibular joint （TMJ） is infrequently reported. We present a case of acute suppurative arthritis of the TMJ that occurred after a mandibular blow. A 71-year-old woman who was receiving prednisolone and methotrexate to treat rheumatoid arthritis was referred to our hospital because of diffuse swelling and pain in the left TMJ, buccal, and orbital regions. A malocclusion with deviation of the mandible to the contralateral side was found. The arthritis appeared 5 days after the patient had sustained an injury to the mandible. Articular space widening, an abscess of the head of the mandible nearby, and massive swelling of the lateral pterygoid muscle were found on CT scans. The condylar head of the mandible was displaced anteriorly. Approximately 2 ml of pus was aspirated by puncture from the upper joint cavity; however, bacterial culture of the pus was negative. The region of the left infratemporal fossa showed an abcess on CT scans during therapy. Treatment with antibiotics （CTM ＋CLDM, and CFPN-PI） yielded an excellent result. After healing in response to treatment, no recurrence has occurred for 48 months.
