[A clinical study on septic arthritis of temporomandibular joint: characteristics and diagnosis].

Objective: To investigate the clinical characteristics and the procedure of early diagnosis of septic arthritis of temporomandibular joint (TMJ).

Methods: 30 consecutive patients with TMJ septic arthritis were included in this clinical study between 1995 and 2001. Physical examinations, joint fluid analyses, radiographic imagings and laboratory studies were performed in all cases. Sequelae were evaluated.

Results: The clinical data showed 29 of the 30 patients were more than 18 years old. The infections of the TMJs were mostly through hematogenous route, and the original infectious sites could not be found in many cases. The obvious inflammatory symptoms in TMJ areas and severe morbidity were not detected in most of the cases (25/30), and a high level of polymorphonuclear cells, and some fibro-protein or cartilage fragments were seen in the synovial fluid. Microorganism were found with Gram staining in 15 of 30 cases, but the culture of bacteria only succeeded in 5 cases. S. saprophyticus and S. aureus were the common kinds of bacteria isolated. The sequelae were mild, and most of the cases had only postinfectious osteoarthritis.

Conclusions: Nowadays TMJ septic arthritis has shown some new characteristics, such as occult original infectious sites, atypical and mild symptoms, and slight sequelae; Joint fluid analysis is necessary for diagnosis.