case_images: PMC11756522_01
case_images: Panoramic radiogram taken upon admission to the emergency department. The left condyle appeares more pronounced compared to the right, showing an enlarged intra-articular space.
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case_images: F1
case_images: The left condyle was more prominent than the right counterpart, with increased intra-articular space (Figure 1).
case_images: CT scan taken upon arrival to the emergency department. The images (A-C) show a significant hypodense area at the anterior part of the left TMJ, demonstrating signs of inflammation, edema, and collection around the left joint. (A) Axial view, (B,C) coronal view. The images (D,E), demonstrate an erosion of the glenoid fossa and the significant bone involvement, suggesting the presence of an advanced pathological condition. Images (D,E) show the sagittal and coronal views, respectively, at the bone window.
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case_images: F2
case_images: A computed tomography (CT) scan revealed features indicative of soft tissue involvement and inflammatory changes, including the presence of a large subperiosteal abscess on the anterior part of the left mandibular condyle (Figures 2A-C). Notably, there was an absence of osteoarthritic radiographic changes in the left condyle (Figures 2A-C). Additionally, the detection of a partial cortical fracture and elevated periosteum in the middle cranial fossa further underscored the severity and extent of bone involvement (Figures 2D,E), indicating that the condition was in an advanced stage.
case_images: T2 sequence MRI of the TMJ, coronal images, revealing hyperintensity and joint effusion on the left joint.
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case_images: F3
case_images: Magnetic resonance imaging (MRI) pinpointed a hyperintense signal, indicating an edema and inflammation in the left joint (Figure 3).
case_images: CT scan two weeks after administration of antibiotics, demonstrating almost total resolution of the collection on the left joint. This notable reduction in the collection demonstrates a positive response to treatment and indicates effective management of this severe condition. (A) Axial view, (B) coronal view.
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case_images: F4
case_images: This included a significant reduction in preauricular edema, with only slight residual swelling, as supported by the radiographic examination (Figure 4), with no signs of redness or local warmth.