TMJ arthritis triggered by Lyme disease

A case report by Weise and colleagues demonstrates that Lyme disease can induce temporomandibular joint (TMJ) ache and could also be misdiagnosed as a typical temporomandibular dysfunction (TMD).

Within the article, “Acute arthritis of the right temporomandibular joint due to Lyme disease: a case report and literature review,” the authors describe a 25-year-old affected person who offered to a medical middle with acute ache in the proper temporomandibular joint and mouth opening problems.¹

Over a 5-year interval, the lady’s distal chew was handled with detachable and glued orthodontic home equipment. Three months after the primary signs, “the affected person developed growing ache in the proper TMJ, growing energetic mouth opening restriction to twenty mm and a ordinary deviation of the decrease jaw to the left.”

The affected person was initially recognized with a complete ventral deviation of the discus on the proper aspect with out discount. Therapy with anti-inflammatory drugs, a chew splint and a corticosteroid injection, nonetheless, weren’t efficient and the lady’s signs continued.

Though the affected person didn’t recall a tick chew or EM rash, testing for Lyme disease was optimistic and she or he was recognized with Lyme arthritis affecting the proper temporomandibular joint.

“Early interdisciplinary analysis of Lyme disease and early antibiotic remedy are important to keep away from misdiagnosis and pointless, generally invasive, therapies.”

The affected person was prescribed a 3-week course of Cefuroxime. After one week of antibiotic therapy, her signs improved.

“It may be assumed that there will need to have been an an infection with Borrelia in the proper temporomandibular joint for an extended time frame earlier than the signs occurred.”

Lyme disease presenting with TMJ “fairly often is misinterpreted as a temporomandibular dysfunction,” the authors state.

“Within the case of unclear TMJ issues and when the TMD therapy shouldn’t be profitable,” the authors stress, “the potential for a [Lyme disease] an infection ought to positively be thought-about as a differential analysis.”