More radiographic interpretation Flashcards

1
Q

What pathologies could come under radiographic jaw lesions?

A

Cysts
Benign neoplasms
Cancers
Developmental abnormalities
Reactive lesions
Genetic conditions

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2
Q

What differential diagnosis are there for suspected lesions on a radiograph?

A

Anatomical
Artefactual
Pathological

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3
Q

What information should you give when describing a radiographic lesion?

A

Site
Size
Shape
Margins
Internal structure
Effect on adjacent anatomy

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4
Q

What information should be given about the SITE of a radiographic lesion?

A

Specific location (which bone is it on)
Notable relationships with other structures (teeth, canals)
Where it is in position to other structures (close to max. sinus)

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5
Q

What information should be given about the SIZE of a radiographic lesion?

A

Measurement mesio-distally by supero-inferiorly
Describe boundaries (extends between 34 and 38)
Volumetric analysis from CBCT

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6
Q

What information should be given about the SHAPE of a radiographic lesion?

A

General - rounded, scalloped, irregular
Locularity - uni-ocular, pseudolocular, multiocular

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7
Q

What information should be given about the MARGINS of a radiographic lesion?

A

Well defined and corticated/non-corticated
Poorly defined and blending in/ragged

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8
Q

What is the significance of a radiographic lesion with a moth-eaten/ragged margin?

A

Suggests malignancy, corticated border indicates benign.

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9
Q

What information should be given about the INTERNAL STRUCTURE of a radiographic lesion?

A

Entirely radiolucent or,
Radiolucent with some internal radiopacity or,
Radiopaque

Internal radiopacities can be described by amount, bony profile, and particular structure.

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10
Q

What makes jaw lesions radiolucent?

A

Resorption of bone
Less mineralization in bone
Less thickness in bone
Replacement of bone with abnormal tissue

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11
Q

What makes jaw lesions radiopaque?

A

Increased thickness of bone
Osteosclerosis of the bone
Presence of abnormal tissue
Mineralization of normally non-mineralized tissues.

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12
Q

How can radiographic jaw lesions impact adjacent anatomy?

A

Some pathologies have characteristic growth
patterns related to their ability to affect adjacent
structures

Aggressive pathologies tend to grow quickly & be
more destructive

Displacement of structures, impaction of teeth, loss of lamina dura, widening of the PDL, erosion of structures.

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13
Q

Describe the lesion presented below.

Exclude size for the purposes of this card.

A

Site: Alveolar bone region of 46, above the right IAC

Shape: Uniocular and rounded

Margins: Well defined and corticated

Internal structure: Entirely radiolucent

Tooth involvement: None, but close to 45

Effects: Non visible

Number: Single

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14
Q

Describe the lesion presented below.

Exclude size for the purposes of this card.

A

Site: Right ramus and post. body of mandible, above IAC

Shape: Pseudolocular and scalloped

Margins: Well defined and corticated

Tooth involvement: Yes, displaced 48 and 47

Effects: Displaced teeth and IAC, thinned inferior cortex of mandible

Number: Single

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15
Q

Describe the lesion presented below.

A

Site: Alveolar bone of 46, above IAC

Shape: Oblong but irregular

Margins: Well defined and smooth

Internal structure: Homogeneously radiopaque

Tooth involvement: Yes involves apicies and furcation of 46

Effects: None

Number: Single

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16
Q

Other than anatomical/artefactual reasons, what can cause periapical radiolucency?

A

Periapical granuloma
Periapical abscess
Radicular cysts
Perio-endo lesion
Cemento-psseous dysplasia
Surgical defect
Fiberous healing defect
Ameloblastoma

17
Q

How can infected cysts mimic radiographic features of malignancy?

A

They can loose their well defined corticated margins, and this should be confirmed with clinical features.

18
Q

What do radiographic jaw lesions contain?

A

Air, fluid, or non-mineralised tissue. They may not appear radiolucent relative to the adjacent tissues.

19
Q

What is idiopathic osteosclerosis?

A

Localised area of increased bone density of unknown cause.

No assoication with pathological process.

Asymptomatic, and generally an incidental finding.

Stops growing by adulthood.

20
Q

What are the radiographic features of idiopathic osteoclerosis?

A

Well defined
No radiolucent margin
Usually less than 2cm wide
Often homegenous, but can have slightly radiolucent areas

21
Q

What is sclerosing osteitis?

A

Localused area of increased bone density, in response to inflammation

Also known as condensing osteitis

Directly associated with source of infection (apex of necrotic tooth, infected cyst etc.

22
Q

What are the radiographic features of sclerosing osteitis?

A

Well defined or poorly defined radiopacity
Variable shape
Visibly linked with source of inflammation

23
Q

What is hypercementosis?

A

Excessive deposition of cementum around the root of a tooth.

Cause unknown, but more common in Paget’s Disease and Acromegaly.

Makes extraction of the tooth more challenging.

24
Q

Describe the radiographic presentation of hypercementosis?

A

Single or multiple teeth involved

Homogeneous radiopacity continuous with the root surface, with subtle difference in density when compared to root dentine.

PDL Space extends around periphery.

Often well defined and smooth margins, but can be irregular.

25
Q

What are buried retained roots?

A

Remnants of incomplete extractions or heavily broken down teeth.

Management only needed if infected, symptomatic, or hampering treatment such as implants.

May appear as diffuse radiopacity due to ERR or sclerosing osteitis of adjacent bone.

26
Q

Identify the abnormality found around the apex of the 43.

A

Retained/sunken root.

27
Q

Identify the blue and purple abnormalities indicated in this image.

A

Blue = Supernumerary tooth
Purple = Sclerosing osteitis or Idiopathic osteosclerosis.