Tuberculosis of Temporomandibular Joint, a Clinical Dilemma With Insidious Course: A Case Series

ABSTRACT Aim We present two cases showcasing distinct clinical presentations of tuberculosis of the temporomandibular joint. Materials and Methods A 40‐year‐old female presented with a swelling in the left pre‐auricular region and difficulty in opening her mouth since 4 months. Cone beam computed tomography showed pronounced rarefaction and destruction of the mandibular condyle with discontinuity of the cortical boundary, suggestive of erosion of the condylar head. The patient was subjected to an excisional biopsy under general anaesthesia, and later a diagnosis of tuberculosis was given. Another patient, a 15‐year‐old male, reported with reduced mouth opening since 5 years, with a past history of tuberculosis of the right temporomandibular joint. Cone beam computed tomography revealed distorted right condylar head anatomy with unilateral bony fusion between the condylar head and glenoid fossa. A diagnosis of primary tuberculosis of the temporomandibular joint leading to unilateral ankylosis was made. Results In the first case, an excisional biopsy was done, which confirmed the presence of tuberculosis, and in the second case, the patient had received anti‐tubercular drugs and was disease‐free; gap arthroplasty was done for ankylosis. Conclusion Tuberculosis of the temporomandibular joint is extremely rare, accounting for less than 2% of skeletal tubercular cases. Early recognition and accurate diagnosis of this insidious disease are crucial for initiating the necessary treatment in time and thus avoiding patient morbidity.