A 15-year-old Thoroughbred gelding was presented for investigation of fever, right temporomandibular region swelling, and progressive pain when opening the mouth. Right temporomandibular joint (TMJ) sepsis was diagnosed based on synovial fluid analysis, sonographic imaging, and standing robotic cone-beam computed tomography. Concurrent otitis media and temporohyoid osteoarthropathy (THO) were also noted. The horse was treated with arthroscopic debridement and lavage during standing sedation followed by local and systemic antimicrobial therapy. There were no complications associated with the surgical procedure and the gelding’s clinical signs resolved. Arthroscopy of the TMJ can be accomplished in the standing horse and should be considered when arthroscopic exploration or debridement of this joint is indicated. This is also the first case report of concurrent otitis media, TMJ sepsis, and THO; due to their close anatomic relationship, it is possible that septic otitis media could lead to pathology in the TMJ and temporohyoid joint, as described in humans.
MollHDMayKA. A review of conditions of the equine temporomandibular joint. In: Proc Annu Conv AAEP; December 4–8, 2002; Orlando, FL.
2.
MayKAMollHDHowardRDPleasantRSGreggJM. Arthroscopic anatomy of the equine temporomandibular joint. Vet Surg. 2001;30(6):564–571.
3.
WellerRMaierlJBowenIMMaySALiebichHG. The arthroscopic approach and intra-articular anatomy of the equine temporomandibular joint. Equine Vet J. 2002;34(4):421–424.
4.
RodríguezMJAgutAGilFLatorreR. Anatomy of the equine temporomandibular joint: study by gross dissection, vascular injection and section. Equine Vet J. 2006;38(2):143–147.
5.
RosensteinDSBullockMEOcelloPJClaytonHM. Arthrocentesis of the temporomandibular joint in adult horses. Am J Vet Res. 2001;62(5):729–733.
6.
RodríguezMJAgutASolerM, et al.Magnetic resonance imaging of the equine temporomandibular joint anatomy. Equine Vet J. 2010;38(2):143–147.
7.
GemmillT. Conditions of the temporomandibular joint in dogs and cats. In Pract. 2008;30(1):36–43.
8.
GayleEAYoungSMMcKennaSJMcNaughtonCD. Septic arthritis of the temporomandibular joint: case reports and review of the literature. J Emerg Med. 2013;45(5):674–678.
9.
IshikawaSWatanabeTIinoM. Acute septic arthritis of the temporomandibular joint derived from otitis media: a report and review of the English and Japanese literature. Oral Maxillofac Surg. 2017;21(1):83–85.
10.
BastFCollierSChadhaPCollierJ. Septic arthritis of the temporomandibular joint as a complication of acute otitis media in a child: a rare case and the importance of real-time PCR for diagnosis. Int J Pediatr Otorhinolaryngol. 2015;79(11):1942–1945.
11.
DevineDVMollHDBahrRJ. Fracture, luxation, and chronic septic arthritis of the temporomandibular joint in a juvenile horse. J Vet Dent. 2005;22(2):96–99.
12.
BarnettTPPowellSEHeadMJMarrCMStevenWNPayneRJ. Partial mandibular condylectomy and temporal bone resection for chronic, destructive, septic arthritis of the temporomandibular joint in a horse. Equine Vet Educ. 2014;26(2):59–63.
13.
WarmerdamEKleinWvan HerpenB. Infectious temporomandibular joint disease in the horse: computed tomographic diagnosis and treatment of two cases. Vet Rec. 1997;141(7):172–174.
14.
WellerRCauvinERBowenIMMaySA. Comparison of radiography, scintigraphy and ultrasonography in the diagnosis of a case of temporomandibular joint arthropathy in a horse. Vet Rec. 1999;144(14):377–379.
15.
CarmaltJLWilsonDG. Arthroscopic treatment of temporomandibular joint sepsis in a horse. Vet Surg. 2005;34(1):55–58.
16.
NagyADSimhoferH. Mandibular condylectomy and meniscectomy for the treatment of septic temporomandibular joint arthritis in a horse. Vet Surg. 2006;35(7):663–668.
17.
WellerRTaylorSMaierlJCauvinERJMaySA. Ultrasonograpic anatomy of the equine temporomandibular joint. Equine Vet J. 1999;31(6):529–532.
18.
RamzanPHLMarrCMMeehanJThompsonA. Novel oblique radiographic projection of the temporomandibular articulation of horses. Vet Rec. 2008;162(22):714–716.
19.
EblingAJMcKnightALSeilerGKircherPR. A complementary radiographic projection of the equine temporomandibular joint. Vet Radiol Ultrasound. 2009;50(4):385–391.
20.
TownsendNBCottonJCBarakzaiSZ. A tangential radiographic projection for investigation of the equine temporomandibular joint. Vet Surg. 2009;50(4):385–391.
21.
RodríguezMJLatorreRLópez-AlborsO, et al.Computed tomographic anatomy of the temporomandibular joint in the young horse. Equine Vet J. 2008;40(6):566–571.
22.
CarmaltJLKneisslSRawlinsonJE, et al.Computed tomographic appearance of the temporomandibular joint in 1018 asymptomatic horses: a multi-institution study. Vet Radiol Ultrasound. 2016;57(3):237–245.
23.
BoeningKJ. Diagnostic and surgical arthroscopy of the equine temporomandibular joint. In: NAVC Proceedings; January 17–21, 2004:118–120; Orlando, FL.
CaiX-YYangCZhangZ-YQiuW-LChenM-JZhangS-Y. Septic arthritis of the temporomandibular joint: a retrospective review of 40 cases. J Oral Maxillofac Surg. 2010;68(4):731–738.
26.
WalkerAMSellonDCCornelisseCJ, et al.Temporohyoid osteoarthropathy in 33 horses (1993-2000). J Vet Intern Med. 2002;16(6):697–703.
27.
WrightIMSmithMRWHumphreyDJEaton-EvansTCJHillyerMH. Endoscopic surgery in the treatment of contaminated and infected synovial cavities. Equine Vet J. 2010;35(6):613–619.
