Septic Arthritis of the TMJ with Rapid Condylar Destruction

A 21-year-old male with no significant medical history presented with pain and swelling on the right masseter with limited range of motion. The radiologist identified severe resorption of the right condyle down to approximately the condylar neck, with periosteal reaction along the condyle and ramus. A comparison scan from three months prior showed an overall normal right condyle, indicating rapid radiographic change. The appearance was most suggestive of septic arthritis, though malignancy could not be ruled out given the rapid destruction. The patient was sent to urgent care and treated with antibiotics, which helped resolve symptoms, supporting the diagnosis. The left condyle showed similar loss of volume that was relatively stable between the two scans. Follow-up imaging at one and three years showed persistent DJD but resolved swelling with no evidence of rapid destruction or periosteal reaction. The radiologist noted that septic arthritis of the TMJ is very rare, and prompt identification helped the patient receive urgent treatment.