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1.
Rev. Odontol. Araçatuba (Online) ; 43(2): 29-34, maio-ago. 2022. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1362016

ABSTRACT

A articulação temporomandibular está vunerável a várias condições de anormalidades já bastante conhecidas, dentre elas, o deslocamento do disco articular sem redução, considerado pela literatura o mais comum das patologias desta região. A deterioração do quadro pode ser um indicativo da necessidade cirúrgica. Em específico, no deslocamento de disco sem redução, o reposicionamento definitivo pode ser adquirido através de discopexia e artrocentese. O presente trabalho tem como objetivo relatar um caso clínico de deslocamento de disco articular bilateral sem redução, apresentando a importância da fisioterapia associada à abordagem cirúrgia na recuperação da função mandibular, bem como, reforçar a importância de uma abordagem conjunta entre análise clínica e imaginológica para resolução de casos. Paciente feminino cursando com diversos sintomas em face e pescoço de forma progressiva ao longo de dois anos foi submetida a cirurgia na articulação temporo-mandibular, onde foi feita a discopexia através de ancoragem dos discos articulares com parafusos. A avaliação física, assim como, a imaginológica, ajudaram na confirmação do diagnóstico. A abordagem cirurgica adotada no tratamento deste caso foi descrita na literatura desde o final do século XIX. Conclui-se que, o método utilizado no tratamento do deslocamento de disco sem redução deve ser baseado nos sinais e sintomas do paciente, cuja abordagem deve ser readequada de acordo com as mudanças do quadro apresentado. Nesta análise, a abordagem cirúrgica associada à fisioterapia específica para as estruturas musculoesquelética da face trouxeram resultados positivos(AU)


The temporomandibular joint is responsible for several well-known conditions of abnormalities, among them, the joint disc displacement without reduction, considered by the literature the most common pathology of this region. Deterioration of the condition may be indicative of surgical need. Specifically, in displacement disc without reduction, definitive repositioning can be achieved through discopexy and arthrocentesis. The aim of the present study is to report a case of unilateral articular disc displacement without reduction, as well the importance of physiotherapy associated with the surgical approach in the recovery of mandibular function, as well as reinforcing the importance of a joint approach between clinical and imaging analysis for case resolution. Female patient with several symptoms in the face and neck progressively over two years, underwent surgery in the temporomandibular joint, where discopexy was performed by anchoring the articular discs with screws. The physical assessment, as well as the imaging, helped to confirm the diagnosis. The surgical approach adopted in the treatment of this case has been described in the literature since the end of the 19th century. In conclusion, the method used to treat articular disc displacement without reduction should be based on the patient's signs and symptoms, whose approach should be readjusted according to the changes in the presented picture. In this analysis, the surgical approach associated with specific physiotherapy for the musculoskeletal structures of the face brought positive results(AU)


Subject(s)
Humans , Female , Adult , Temporomandibular Joint Disc , Temporomandibular Joint Disc/injuries , Joint Dislocations , Temporomandibular Joint/injuries , Physical Therapy Modalities , Temporomandibular Joint Disc/surgery , Temporomandibular Joint Disc/diagnostic imaging , Arthrocentesis
2.
Rev. Asoc. Odontol. Argent ; 109(3): 185-189, dic. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1373088

ABSTRACT

Objetivo: El objetivo de este reporte de caso es presen- tar a la artrocentesis como una alternativa quirúrgica mínima- mente invasiva en el tratamiento de la artritis séptica tempo- romandibular. Caso clínico: Un paciente hombre de 26 años con an- tecedente de flegmón perimandibular derecho tratado, acude a la Unidad Hospitalaria de Cirugía Maxilofacial por dolor articular temporomandibular, impotencia funcional y trismus, a un mes de haber sido dado de alta de un primer cuadro infec- cioso. Luego de los exámenes clínicos y complementarios, se diagnostica artritis séptica de articulación temporomandibular derecha, la cual fue tratada quirúrgicamente mediante dos ar- trocentesis acompañadas de terapia farmacológica (AU)


Aim: The aim of this case report is to present arthrocen- tesis as a minimally invasive surgical alternative in the treat- ment of temporomandibular septic arthritis. Clinical case: A 26-year-old male patient, with a his- tory of treated right perimandibular phlegmon, came to the Maxillofacial Surgery Hospital Unit due to temporomandibu- lar joint pain, functional impairment and trismus, one month after having recovered from his first infectious process. After clinical and complementary examinations, septic arthritis of the right temporomandibular joint was diagnosed, which was treated surgically by means of two arthrocenteses and phar- macological therapy (AU)


Subject(s)
Humans , Male , Adult , Arthritis, Infectious , Temporomandibular Joint Disorders , Arthrocentesis , Trismus , Chile , Dental Service, Hospital
3.
Prensa méd. argent ; 107(8): 418-422, 20210000. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1358673

ABSTRACT

Las betalactamasas de espectro extendido (BLEE) son enzimas producidas por bacilos gram negativos capaces de hidrolizar las cefalosporinas de amplio espectro y los monobactámicos. La mayoría pertenece a la familia de Enterobacteriae, tales como Klebsiella pneumoniae y Escherichia coli: Sin embargo, se asocian también con otras bacterias como Proteus, Serratia, Salmonella, Pseudomonas aeruginosa y Acinetobacter. Las enterobacterias productoras de carbapenemasas no sólo han sido aisladas en el ambiente hospitalario, sino que también provienen de la comunidad. Se presenta una paciente de sexo femenino con antecedentes de sida y osteomielitis secundaria a artritis séptica producida por una Klebsiella pneumoniae BLEE de la comunidad. Un tratamiento oportuno y eficaz puede evitar la opción quirúrgica, disminuyendo la morbimortalidad asociada con esta afección


Extended-spectrum beta-lactamases (ESBL) are enzymes produced by gram-negative rods capable of hydrolyzing broad-spectrum cephalosporins and monobactams. Most belong to the Enterobacteriae family, such as Klebsiella pneumoniae and Escherichia coli. However, they are also associated with other bacteria such as Proteus, Serratia, Salmonella, Pseudomonas aeruginosa and Acinetobacter. Carbapenemase-producing Enterobacteriaceae have not only been isolated from the hospital environment, but also from the community. We present a female patient with a history of AIDS and secondary osteomyelitis to septic arthritis caused by a community Klebsiella pneumoniae ESBL. It is concluded that a timely and effective treatment can avoids the surgical option, reducing the morbidity and mortality of this condition.


Subject(s)
Humans , Female , Adult , Osteomyelitis/immunology , Klebsiella Infections/therapy , Arthritis, Infectious/therapy , Imipenem/therapeutic use , AIDS-Related Opportunistic Infections/immunology , Arthrocentesis , Knee Injuries/therapy
4.
Clinics ; 76: e2840, 2021. tab
Article in English | LILACS | ID: biblio-1249590

ABSTRACT

OBJECTIVES: Arthrocentesis is the simplest surgical intervention for the temporomandibular joint (TMJ). It can be performed on an outpatient basis at a low cost and with low morbidity. The objective is to release the articular disc by disrupting the adhesion formed between its surfaces and the mandibular fossa through hydraulic pressure generated by irrigation of the upper compartment of the TMJ. Viscosupplementation with hyaluronic acid during or after arthrocentesis improves clinical outcomes, increases mouth opening, and reduces pain levels. The aim of this study was to evaluate the efficiency of arthrocentesis plus hyaluronic acid viscosupplementation through clinical examination and preoperative magnetic resonance imaging in patients with unilateral disc displacement without reduction (DDwoR). METHODS: This analytical retrospective cross-sectional study clinically and radiologically evaluated 72 patients of both sexes with unilateral DDwoR. The following data were collected: sex, pain, age, duration of pain, maximum mouth opening, and patient pain perception on a visual analog scale. TMJ arthrocentesis was performed only once for each of the indicated joints. Data were collected before arthrocentesis (baseline) and at 7, 14, 30, 60, 90, and 180 days after the procedure (final evaluation). RESULTS: Between the baseline and final evaluation, there was a significant reduction in pain (p=0.001) and restoration of articular function. In addition, there was a significant increase in maximum mouth opening (p=0.001). CONCLUSION: Patients with DDwoR undergoing arthrocentesis combined with hyaluronic acid injection showed significant improvement in the perceived pain and maximum mouth opening in the mid-term follow-up periods.


Subject(s)
Humans , Male , Female , Joint Dislocations , Viscosupplementation , Cross-Sectional Studies , Retrospective Studies , Range of Motion, Articular , Treatment Outcome , Temporomandibular Joint Disc , Arthrocentesis
5.
Braz. dent. sci ; 24(2): 1-8, 2021. tab, ilus
Article in English | LILACS, BBO | ID: biblio-1177389

ABSTRACT

Objetive: This study was to compare the effectiveness of arthrocentesis versus the insertion of anterior repositioning splint (ARS) in improving the mandibular range of motion (MRM) for patients with the temporomandibular joint (TMJ) anterior disc displacement with reduction (ADDwR). Methods: 36 patients diagnosed as ADDwR were recruited and divided randomly into two groups. The first group (G1) was treated by arthrocentesis, and the second (G2) was treated using ARS. All patients were reexamined after six months. Results: Except that for protrusive movement, there were significant differences between the two groups for the percentage changes of the MRM as measured by the amount of pain free opening, unassisted opening, maximum assisted opening, right lateral and left lateral movements (p < 0.05). Conclusion: Within the context of the current study, the non-invasive, lower cost ARS, provided better results in improving the MRM when managing ADDwR cases. (AU)


Objetivo: O presente estudo comparou a eficácia da Artrocentese em relação à inserção da Placa Reposicionadora Anterior (PRA) na melhoria da Amplitude de Movimento Mandibular (AMM) para pacientes que apresentam Deslocamento de Disco Anterior com Redução (DDAcR) da Articulação Temporomandibular (ATM). Método: 36 pacientes diagnosticados como DDAcR foram recrutados e divididos aleatoriamente em dois grupos. O primeiro grupo (G1) foi tratado através da Artrocentese e o segundo (G2), tratado com a PRA. Todos os pacientes foram reexaminados após seis meses. Resultados: Com exceção do movimento protrusivo, houve diferenças significativas entre os dois grupos para as mudanças percentuais das medidas de AMM pela quantidade de abertura sem dor, abertura sem assistência, abertura máxima com assistência, movimentos laterais direitos e laterais esquerdos (p < 0,05). Conclusão: Dentro do contexto do estudo atual, a PRA, não invasiva e de menor custo, proporcionou melhores resultados na melhoria da AMM no gerenciamento de casos de DDAcR (AU)


Subject(s)
Humans , Male , Female , Temporomandibular Joint , Arthrocentesis , Intervertebral Disc Displacement
6.
Rev. cient. odontol ; 7(1): 121-131, ene.-jun. 2019.
Article in Spanish | LILACS, LIPECS | ID: biblio-1005981

ABSTRACT

Este artículo involucra una revisión de los factores etiológicos asociados a la osteoartritis (OA) de la articulación temporomandibular (ATM), así como los hallazgos imagenológicos, los cuales son indispensables para el diagnóstico y la determinación de la etapa de evolución de esta patología. Además, se discuten los métodos de tratamiento invasivos y no invasivos. Los objetivos del presente artículo fueron describir los métodos de diagnóstico y tratamiento más actuales y eficientes para la osteoartritis de la articulación temporomandibular, y determinar la existencia de la correlación clínica e imagenológica en las diferentes etapas de esta patología. A partir de una revisión de la literatura, se encontró que el método de diagnóstico más relevante para la OA de la ATM es la tomografía computarizada de haz cónico (TCHC), por sus múltiples ventajas. El método de tratamiento más eficiente durante la etapa sintomatológica de la enfermedad es la artrocentesis sinergizada con ácido hialurónico o plasma rico en plaquetas. Cabe resaltar que no se encontraron correlaciones directas suficientes entre los cambios óseos y la sintomatología clínica de la OA de ATM empleando la TCHC. (AU)


The objectives of this article were to describe the most current and efficient diagnostic and treatment methods for osteoarthritis of the temporomandibular joint (TMJ) and to determine the correlation of clinical and imaging in the different stages of this pathology. We review the etiological factors associated with osteoarthritis (OA) of the TMJ as well as the imaging findings, which are essential for the diagnosis and determination of the stage of evolution of this pathology. In addition, invasive and noninvasive treatment methods are discussed. Based on review of the literature, the most relevant diagnostic method for OA of the TMJ is conic beam computed tomography (CBCT), due to its multiple advantages. The most efficient treatment method during the symptomatic stage of the disease is arthrocentesis synergized with hyaluronic acid or plateletrich plasma. It was of note that no direct correlation was found between bone changes and the clinical symptomatology of TMJ OA using CBCT. (AU)


Subject(s)
Humans , Osteoarthritis/therapy , Osteoarthritis/diagnostic imaging , Temporomandibular Joint , Magnetic Resonance Spectroscopy , Cone-Beam Computed Tomography , Arthrocentesis
7.
Article in English | WPRIM | ID: wpr-740002

ABSTRACT

This case report aims to review complications that can occur during arthrocentesis and report an unusual complication observed in a 55-year-old man. The patient received arthrocentesis in an attempt to treat painful locking episodes of his right temporomandibular joint (TMJ). One hour after the operation, the patient experienced temporary facial paralysis in the area of the facial nerve and anesthesia of the lingual and alveolar inferior nerves. No persistent complications were detected during the postoperative follow-up. We suspected this complication occurred after anesthetic solution overflowed from a traumatic perforation in the joint capsule to the infratemporal area during the operation. To our knowledge, this complication has not been previously reported in the literature.


Subject(s)
Anesthesia , Arthrocentesis , Facial Nerve , Facial Paralysis , Follow-Up Studies , Humans , Joint Capsule , Middle Aged , Paralysis , Temporomandibular Joint
8.
Article in English | WPRIM | ID: wpr-739996

ABSTRACT

OBJECTIVE: Arthrocentesis is a minimally invasive surgical procedure that is used to alleviate the symptoms of temporomandibular joint (TMJ) disorders. The aim of this study was to investigate the effect of arthrocentesis on the blood supply to the retinal structures. MATERIALS AND METHODS: Arthrocentesis was performed on 20 patients with TMJ disorders, and choroidal thickness (CT) in patients was measured to evaluate retinal blood circulation. The blood volume of the retinal structures was evaluated ipsilaterally before and after arthrocentesis, and these measurements were then compared with measurements obtained from the contralateral side. RESULTS: Before arthrocentesis, there were no differences in retinal blood volumes between the ipsilateral and contralateral sides (P = 0.96). When ipsilateral CT measurements taken before and after arthrocentesis were compared, retinal blood supply was found to have significantly decreased after arthrocentesis (P = 0.04). When contralateral CT measurements taken before and after arthrocentesis were compared, retinal blood supply was also found to have decreased after arthrocentesis, but not significantly (P = 0.19). CONCLUSION: The solution of local anesthesia with epinephrine applied before the arthrocentesis procedure was found to reduce the blood volume of the retinal structures. To the best of our knowledge, this is the first study that has investigated the blood volume of the retinal structures following arthrocentesis.


Subject(s)
Anesthesia , Anesthesia, Local , Arthrocentesis , Blood Circulation , Blood Volume , Choroid , Epinephrine , Humans , Retinaldehyde , Temporomandibular Joint Disorders , Temporomandibular Joint
9.
Article in English | WPRIM | ID: wpr-766315

ABSTRACT

OBJECTIVES: This study aimed to evaluate the effect of clinical factors on the outcome of arthrocentesis in the treatment of temporomandibular joint (TMJ) internal derangement. MATERIALS AND METHODS: Fifty patients with TMJ internal derangement underwent arthrocentesis using ringer's lactate. The present study evaluated the contribution of the clinical variables of age, time since onset, visual analogue scale (VAS) pain level, and range of motion (ROM) on the outcomes of TMJ arthrocentesis: age (≤25 years, >25 and ≤40 years, >40 and ≤60 years), VAS pain level (≤5, >5 and ≤7, >7 and ≤10), and ROM ( 7 (OR, 11.25; P=0.039), and a maximum vertical opening of < 25 mm (OR, 7.70; P=0.038). CONCLUSION: Lavage of the superior joint space with ringer's lactate resulted in significant reduction in pain and improvement in mouth opening. Patients with a greater inflammatory component and younger patients benefitted more from arthrocentesis. Evaluation of these clinical variables helped in predictive modelling, which may provide clinicians with the opportunity to identify “at-benefit” patients early and initiate specific treatment.


Subject(s)
Arthrocentesis , Humans , Joints , Lactic Acid , Logistic Models , Mouth , Odds Ratio , Range of Motion, Articular , Temporomandibular Joint , Therapeutic Irrigation
10.
Article in English | WPRIM | ID: wpr-766314

ABSTRACT

OBJECTIVES: The aim of this study was to use four sets of success criteria to evaluate the outcomes of arthrocentesis treatment with hyaluronic acid injection in patients with internal derangement (ID) of the temporomandibular joint (TMJ). MATERIALS AND METHODS: The study included 40 patients diagnosed with unilateral Wilkes stage III TMJ dysfunction. Clinical parameters, including maximum mouth opening (MMO) and pain during function, were evaluated preoperatively, 6 months, and 1 year after TMJ arthrocentesis. Outcomes were assessed and compared using four sets of success criteria from the following: the American Association of Oral and Maxillofacial Surgeons (AAOMS; MMO ≥35 mm and visual analogue scale [VAS] score ≤3), Murakami et al.'s criteria (MMO >38 mm and VAS score 50% pain reduction), and patient self-reports (self-evaluation of treatment as successful or unsuccessful). RESULTS: Significant improvements in MMO and pain reduction during function were observed between the preoperative period and 6 months and 1 year postoperatively (P < 0.01). The success rates of treatment determined using AAOMS (52.5%), Emshoff and Rudisch criteria (57.5%), and self-reported patient criteria (40.0%) were similar. Application of the Murakami et al. criteria reported the lowest success rate (12.5%). CONCLUSION: The AAOMS and Emshoff and Rudisch criteria are consistent with patient expectations and can be used to assess treatment efficacy.


Subject(s)
Arthrocentesis , Humans , Hyaluronic Acid , Mouth , Oral and Maxillofacial Surgeons , Preoperative Period , Temporomandibular Joint Disorders , Temporomandibular Joint , Treatment Outcome
11.
Article in English | WPRIM | ID: wpr-764996

ABSTRACT

BACKGROUND: We aimed to assess the performance of the 2015 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria for gout in Korean patients with acute arthritis and to compare the performance of the ACR/EULAR criteria to that of other sets of criteria for gout classification. METHODS: Patients with acute arthritis who underwent diagnostic arthrocentesis at one of the four participating rheumatology clinics were consecutively enrolled between February and December 2017. Crystal-proven gout was diagnosed upon confirming the presence of monosodium urate (MSU) crystals in patients with a clinical impression of gout as judged by the rheumatologist. The performance of the ACR/EULAR and other gout classification criteria, including the Rome, New York, American Rheumatism Association (ARA), Mexico, and Netherlands criteria, was analyzed regardless of the presence/absence of MSU crystals. RESULTS: The study enrolled 118 gout patients (all crystal-proven) and 95 non-gout patients. According to the area under the curve, the diagnostic performance was the highest for the ACR/EULAR classification criteria (sensitivity, 80.5%; specificity, 95.8%; area under the curve, 0.966), followed by the Netherlands, Rome, ARA, New York, and Mexico criteria. All six sets of criteria demonstrated lower sensitivity in patients exhibiting the first episode of acute arthritis. CONCLUSION: In Korean patients with acute arthritis, the ACR/EULAR classification criteria outperformed other sets of gout classification criteria even in the absence of information regarding the presence of MSU crystals. However, to enhance diagnostic sensitivity, synovial fluid analysis should be considered in patients with the first episode of acute arthritis.


Subject(s)
Arthritis , Arthrocentesis , Classification , Gout , Humans , Mexico , Netherlands , Rheumatic Diseases , Rheumatology , Sensitivity and Specificity , Synovial Fluid , Uric Acid
12.
Cambios rev. méd ; 17(2): 12-16, 28/12/2018. graf
Article in Spanish | LILACS | ID: biblio-1005225

ABSTRACT

INTRODUCCIÓN. La artritis séptica aguda de rodilla puede provocar daño grave en las articulaciones o sepsis, si no se logra un diagnóstico y tratamiento precoz, lo que incluye drenaje de la articulación, cobertura adecuada de antibióticos y reposo de rodilla. Clásicamente, el drenaje de la rodilla se realiza con múltiples artrocentesis o con artrotomía. El abordaje artroscópico es cada vez más aceptado, pues permite el drenaje adecuado del material purulento y el desbridamiento con la sinovectomía parcial o total de la articulación. OBJETIVO. Evaluar las diferencias entre la artroscopia y la artrotomía en los resultados clínicos y la tasa de recurrencia en pacientes con artritis séptica de la articulación de rodilla. MATERIALES Y MÉTODOS. Revisión de 20 artículos científicos de los últimos 5 años de publicación. Además se analizó los artículos seleccionados para este estudio, como criterios de inclusión se revisaron los que contenían recomendaciones acerca de artrotomía vs artroscopia en el tratamiento de la artritis séptica aguda, excluyendo otro tipo de procedimientos quirúrgicos. RESULTADOS. Se hizo una selección aleatoria de artículos científicos. No existió diferencia en la efectividad del tratamiento en ambos grupos. El dolor fue más alto en los sometidos a tratamiento por artrotomía a los 7 y 14 días postoperatorios. El regreso a las actividades de la vida diaria tomó un promedio de 5,7 días para ambos grupos: 7,1 días para el grupo de artrotomía y 4,3 días para el grupo de artroscopia. CONCLUSIÓN. Esta revisión recolectó información sin evidencia concluyente que demuestre que la artroscopia es más efectiva en el manejo de la artritis séptica. La artrotomía se mantiene como terapéutica estándar en el tratamiento de la artritis séptica de rodilla.


INTRODUCTION. Acute knee septic arthritis can cause serious joint damage or sepsis if early diagnosis and treatment is not achieved, including drainage of the joint, adequate antibiotic coverage and knee rest. Classically, the knee is drained with multiple arthrocentesis or arthrotomy. The arthroscopic approach is increasingly accepted, since it allows adequate drainage of purulent material and debridement with partial or total synovectomy of the joint. OBJECTIVE. To assess the differences between arthroscopy and arthrotomy in clinical outcomes and the recurrence rate in patients with septic arthritis of the knee joint. MATERIALS AND METHODS. Review of 20 scientific articles of the last 5 years of publication. In addition, the articles selected for this study were analyzed, as inclusion criteria were reviewed, which included recommendations about arthrotomy vs arthroscopy in the treatment of acute septic arthritis, excluding other types of surgical procedures. RESULTS A random selection of scientific articles was made. There was no difference in the effectiveness of the treatment in both groups. The pain was highest in those undergoing arthrotomy treatment at 7 and 14 days postoperatively. The return to activities of daily life took an average of 5,7 days for both groups: 7,1 days for the arthrotomy group and 4,3 days for the arthroscopy group. CONCLUSION. This review collected information without conclusive evidence demonstrating that arthroscopy is more effective in the management of septic arthritis. Arthrotomy remains the standard therapy in the treatment of septic knee arthritis.


Subject(s)
Humans , Arthroscopy , Arthritis, Infectious , Drainage , Evaluation of Results of Therapeutic Interventions , Arthrocentesis , Knee Joint
13.
Article in English | WPRIM | ID: wpr-764778

ABSTRACT

Occlusion may change spontaneously but dental treatment or trauma in the patients with temporomandibular disorders (TMDs) may also alter occlusion. This report presents three cases displaying occlusal changes. Review of literature emphasizes the significance of TMD treatment. Conservative treatment modalities such as counseling, medication, physical therapy and splint therapy may be selected as initial treatment options. Irreversible or invasive treatment, such as orthodontic, prosthodontic, and occlusal adjustment should not be attempted early. In case there is no response to conservative treatment, joint injection, muscle injection, arthrocentesis or arthroscopic surgery might be performed.


Subject(s)
Arthrocentesis , Arthroscopy , Counseling , Humans , Joints , Occlusal Adjustment , Splints , Temporomandibular Joint Disorders , Temporomandibular Joint
15.
Rev. cir. traumatol. buco-maxilo-fac ; 17(3)jul.-set. 2017. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1281048

ABSTRACT

A artrocentese é um procedimento minimamente invasivo, realizado na articulação têmporo-mandibular com baixo risco de complicações, alta taxa de sucesso e baixo custo operacional. Pode ser realizada sob anestesia geral ou local, sendo considerada de primeira linha para pacientes portadores de disfunção têmporo-mandibular que não responderam à terapia conservadora. Dentre suas indicações de tratamento, estão o deslocamento do disco articular com ou sem redução, limitação da abertura bucal de origem articular, dor articular e outros desarranjos internos na articulação. A técnica tradicional consiste em lavar e injetar medicações no espaço articular, utilizando duas agulhas, sendo uma posicionada para a entrada da solução e a outra para sua saída. Este trabalho tem por objetivo relatar um caso clínico de paciente do sexo masculino, 32 anos de idade, encaminhado ao Serviço de Cirurgia e Traumatologia Buco-Maxilo-Facial do Hospital Adão Pereira Nunes /RJ, relatando queixas álgicas e limitação de sua abertura bucal, tendo sido proposto, como tratamento inicial, a artrocentese. Após sete dias do tratamento, ele retornou com sua abertura bucal normal e sem queixas álgicas na região. Além disso, serão abordadas, no presente estudo, as indicações da artrocentese, técnicas e medicações descritas na literatura... (AU)


Arthrocentesis is a minimally invasive procedure, performed in the temporomandibular joint with low risk of complications, high success rate and low operating costs. It can be performed under general or local anesthesia and is considered first-line patients with temporomandibular dysfunction unresponsive to conservative therapy. Among its treatment indications are the articular disk displacement with or without reduction, limitation of mouth opening articular origin, joint pain and other internal disorders in the joint. The traditional technique involves washing and injecting medications into the joint space using two needles, one being positioned for solution inlet and the other to its output. This study aims to report a case of a male patient, 32 years old, referred to the Maxillofacial Surgery Adão Pereira Nunes Hospital / RJ, reporting pain complaints and limitations of the mouth opening , whom was proposed the arthrocentesis as initial treatment. After seven days of treatment, he returned to his normal mouth opening without pain complaints in the oral region. Furthermore, this study is to discuss beyond the arthrocentesis indications, the techniques and commonly used medications described in the literature... (AU)


Subject(s)
Humans , Male , Adult , Temporomandibular Joint , Temporomandibular Joint Disorders , Arthrocentesis , Conservative Treatment
16.
Article in English | WPRIM | ID: wpr-648365

ABSTRACT

Traumatic or spontaneous hemarthroses are an important cause of joint effusions, and can complicate innate or acquired coagulopathies. The elbow is an unusual location for a spontaneous hemarthrosis; we describe a previously unreported case of warfarin-induced spontaneous elbow hemarthrosis, diagnosed by point-of-care ultrasound. On the basis of clinical and ultrasound findings arthrocentesis was deferred, and the patient was successfully treated with warfarin reversal and conservative care. Physical examination is unreliable for the detection of a joint effusion, and misdiagnosis and can lead to unnecessary investigation or resource use. Point-of-care ultrasound allows accurate, prompt, direct visualization of a joint effusion, and non-invasive confirmation of a hemarthrosis. Ultrasound can facilitate accurate diagnosis and characterization of joint effusions to improve the care of patients with coagulopathy.


Subject(s)
Arthrocentesis , Diagnosis , Diagnostic Errors , Elbow , Hemarthrosis , Humans , Joints , Physical Examination , Point-of-Care Systems , Ultrasonography , Warfarin
17.
Article in English | WPRIM | ID: wpr-163853

ABSTRACT

Septic arthritis of the temporomandibular joint (TMJ) is a rare disease. The most common symptoms of this disease are acute malocclusion, limited mouth opening, swelling, and tenderness of affected TMJ. These symptoms are often confused with internal derangement of the articular disc, rheumatoid arthritis, retrodiscitis, or osteoarthritis. Therefore, differential diagnosis by image examination is required. Usually, antimicrobial treatment and surgical drainage by needle aspiration, arthroscopy, or arthrotomy are effective treatment approaches. In this study, a patient who was diagnosed with septic arthritis was treated with arthrocentesis and antibiotics without significant complications. We present a case report with a review of the literature.


Subject(s)
Anti-Bacterial Agents , Arthritis, Infectious , Arthritis, Rheumatoid , Arthrocentesis , Arthroscopy , Diagnosis, Differential , Drainage , Humans , Malocclusion , Mouth , Needles , Osteoarthritis , Rare Diseases , Temporomandibular Joint
18.
Article in Chinese | WPRIM | ID: wpr-317759

ABSTRACT

<p><b>OBJECTIVE</b>This study aims to evaluate the effectiveness of arthrocentesis on Wilkes III stage patients. Clinical examinations and magnetic resonance imaging (MRI) findings before treatment and six months after treatment were compared and analyzed.</p><p><b>METHODS</b>A total of 137 outpatients diagnosed with temporomandibular joint internal derangement (TMJID) associated with Wilkes III stage through clinical examination and MRI findings from January 2013 to December 2013 were randomly included. All the patients were successfully treated with arthrocentesis. Moreover, all the patients accepted clinical and MRI examination before arthrocentesis treatment and six months after. Clinical examination included visual analogue scale and opening degree, whereas MRI examination included articular disc morphology and effusion in the upper compartments. Statistical analysis was performed using SPSS 20.0.</p><p><b>RESULTS</b>Results showed that the average score of visual analogue scale six months after treatment was significantly lower than that before treatment (P < 0.05). The success rate was 78.1% (107/137). The rate of disc deformity after arthrocentesis treatment was higher than that before the treatment. By contrast, the positive rate of effusion after arthrocentesis was significantly lower than that before the treatment (P < 0.05). Bilaminar zone adaptive changes (disk-like) were found in seven cases (5.1%, 7/137) after treatment.</p><p><b>CONCLUSION</b>Arthrocentesis could effectively relieve pain of the TMJID patients. Furthermore, MRI results indicated that arthrocentesis could significantly decrease articular effusion. Arthrocentesis was effective for the treatment of Wilkes III stage in the short term. Adaptive changes in bilaminar zone occurred in a few patients. However, serious disc deformity with the passage of time is a trend that has been observed.</p>


Subject(s)
Arthrocentesis , Humans , Joint Dislocations , Magnetic Resonance Imaging , Outpatients , Range of Motion, Articular , Temporomandibular Joint Disc , Pathology , General Surgery , Temporomandibular Joint Disorders , Diagnosis , General Surgery , Treatment Outcome , Visual Analog Scale
19.
Article in English | WPRIM | ID: wpr-20556

ABSTRACT

Arthroscopy is useful to detect early changes in the temporomandibular joint (TMJ). Despite great advances in arthroscopy, many arthroscopic surgeries have now been replaced by arthrocentesis. We propose a simple diagnostic and therapeutic method having operative rigid ultra-thin arthroscopy with 16 gauge needle size combined with arthrocentesis.


Subject(s)
Arthrocentesis , Arthroscopy , Methods , Needles , Temporomandibular Joint
20.
Article in English | WPRIM | ID: wpr-632922

ABSTRACT

BACKGROUND: Non traumatic osteonecrosis also known as  avascular necrosis (AVN),and tuberculous arthritis (TB    arthritis)most commonly present as chronic monoarticular conditions. Corticosteroid intake is known to predispose individuals to the development of these two conditions.                       In AVN, corticosteroid remains to be the most common cause that leads to a final  common pathway of disrupting    blood supply to segments of bone causing cell death. In TB arthritis, corticosteroid renders  a patient relatively immunocompromised predisposing to this extrapulmonary infection.                                                                                                                                                          The incidence of tubercular osteonecrosis in a patient with systemic lupus erythematosus is rare. A review of literature only showed one case report of tubercular osteonecrosis diagnosed by aspiration cytology. Since tuberculosis (TB) is a destructive but curable disease, early diagnosis  and  treatment  are essential.OBJECTIVE: To present a case of tubercular osteonecrosis in a patient with systemic lupus erythematosus treated with anti-Koch's regimen and iloprost infusion.CASE: A 27-year old Filipino female who was diagnosed with lupus nephritis and underwent three days  methylprednisolone pulse therapy. Lupus nephritis improved  and  was clinically inactive for two years. She  developed insidious onset of intermittent pain on her left knee, associated with swelling for four months with  subsequent right hip pain of one week duration. MRI of the left knee showed osteonecrosis and arthritis. Radiograph of the right hip showed osteonecrosis. She underwent arthrocentesis of the left knee and the synovial  fluid tested positive for tuberculosis by PCR. We started the patient on quadruple anti-Koch's regimen together with iloprost infusion which afforded clinical improvement.  CONCLUSION: To our knowledge, this is the first reported case of a lupus patient with concomitant polyarticular osteonecrosis complicated by monoarticular tuberculous arthritis. Medical treatment, while it may be complicated by adverse drug events, is effective in symptomatic treatment, but a multidisciplinary approach is suggested for optimal outcome.


Subject(s)
Humans , Female , Adult , Adrenal Cortex Hormones , Arthritis , Arthrocentesis , Cell Death , Early Diagnosis , Iloprost , Incidence , Lupus Erythematosus, Systemic , Lupus Nephritis , Methylprednisolone , Osteonecrosis , Pain , Polymerase Chain Reaction , Tuberculosis, Osteoarticular
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