Ultrasound Guided Intra-articular Steroid Injection for Temporo Mandibular Joint Arthritis – A Case Report.

ABSTRACT

Introduction: Temporo-mandibular joint (TMJ) arthritis isone of the distressing features of many polyarthritic disordersbecause of interference with mastication. Usually bilateraljoint affection may be a part a larger profile of multiplejoint involvements. Yet, it can present as an isolated entity.Establishing analgesia and improving mouth opening are thekey features in the management of the case.Case report A 23 year old male with no co-morbiditiespresented with restricted and painful mouth opening anddifficulty in mastication for the past two months. He wasdiagnosed as bilateral temporo-mandibular joint arthritis andreferred to us for pain control. Routine investigations werenormal. Ultrasound guided intra-articular temporo-mandibularjoint injection was administered with a combination ofbupivacaine and methylprednisolone bilaterally. There wasa significant improvement in mouth opening and pain scoreVAS < 3 and on a three month follow up, there was no sideeffects and no requirement for further analgesics.Conclusion: We present such a unique case since there is verylittle literature on effectiveness of ultrasound guided intraarticular steroid injection on a case of isolated TMJ arthritisin Indian population.