BMJ Case Reports 2018; doi:10.1136/bcr-2017-223563
  • Rare disease

Septic arthritis of the temporomandibular joint leading to an epidural abscess

Editor's Choice
  1. Johannes Hachleitner
  1. Oral and Maxillofacial Surgery, University Hospital Salzburg, Salzburg, Austria
  1. Correspondence to Dr Joern Wittig, joern.wittig{at}
  • Accepted 26 May 2018
  • Published 11 June 2018


Septic arthritis of the temporomandibular joint (TMJ) is rare, but patients with this diagnosis are at high risk for significant morbidity. We present a case of a 15-year-old man who presented with increasing trismus for 3 days. He had only minimal discomfort and swelling of the right cheek and temporal region, and pericoronitis of an impacted wisdom tooth was suspected. Under intravenous antibiotics, pain subsided, but trismus and a slight swelling remained. CT scan showed septic arthritis of the TMJ with an abscess formation penetrating into the epidural space. Immediate drainage and craniotomy were performed. Under intravenous antibiotics, the patient made a full recovery. The source of infection remained undetermined. To our knowledge, this is the first reported case of septic arthritis of the TMJ spreading into the epidural space.


  • Contributors JW: study design, data collection, manuscript writing. FB: data collection, manuscript review. AG: manuscript review. JH: study design, manuscript review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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