Septic Arthritis of the Temporomandibular Joint Secondary to Disseminated Odontogenic Infection with Severe Systemic Involvement: A Case Report

Abstract

Septic arthritis (SA) of the temporomandibular joint (TMJ) is a rare but clinically significant manifestation of odontogenic infections. It is characterized by an acute or chronic infection of the joint space, caused by bacterial or fungal microorganisms, and its diagnosis is often challenging due to its variable and nonspecific clinical presentation. We report the case of a 78-year-old female patient who presented to the emergency department with right hemifacial swelling, trismus, dysphagia, progressive pain, asthenia, and adynamia, three days after undergoing an unspecified dental procedure. The clinical presentation warranted hospitalization for life support and management through intravenous antibiotic therapy and aggressive surgical intervention. A follow-up computed tomography (CT) scan revealed inflammatory changes in the joint and condylar resorption, consistent with SA of the TMJ. Consequently, an intra-articular lavage via arthroscopy was performed. This case highlights the importance of considering SA of the TMJ as a potential complication of septic conditions involving adjacent anatomical spaces. Timely diagnosis requires appropriate correlation among patient history, clinical findings, imaging studies, and laboratory tests.