Flashcards in Exam 1.12: Panographic Radiology Viewing and Evaluating Deck (68)
What should you do to create an environment suitable for reading a pan?
Viewbox with strong illumination and reduced ambient light
Hot spot, magnifying glass, and hood are helpful too
What order should you evaluate in?
Soft Tissue Shadows
Teeth are last
What is the first bony structure to evaluate
Right Coronoid Process
How might the coronoid process appear in relation to the zygomatic arch
Inferior, Superimposed, or slightly above
How do you know if the coronoid process is usually tall
If it is more than 1 cm above the midpoint of the superior border of the arch
What is the term for a tall coronoid arch?
What type of movement is hindered by coronoid hyperplasia?
Anteriomedial translatory.....patient has trouble fully opening mouth
What can be suspected if the coronoid hyperplasia is only on one side?
What patients will you see bilateral coronoid hyperplasia on?
Teen males thanks to excess growth hormone receptors on coronoid process
This appears as a semilunar rarefaction just below and medial to the sigmoid notch.
Medial sigmoid depression
What do you examine after the coronoid process?
The condylar head of the mandible
How might you determine if bone pathology is due to a break or inflammatory disease?
A break would include damage to the cancellous bone
Inflammatory disease would be limited to the cortical bone
If you see cortical rim degeneration and the patient's blood work has elevated RA factor, IgM, and erythrocyte sedimentation rate, what would you suggest is the problem?
What fibrous structure covers the articular surfaces of the joint in RA?
What does the pannus have that physically destroys the joint surfaces and cartilage?
The pannus is filled with macrophages, proteases, and collagenases
If too much of the condylar head is resorbed, it leaves a sharp residual shape...what often occurs next
Perforation of the disk
What are two rare causes of the condylar degeneration in patient's without RA?
Regional spread of a parotid gland cancer
Primary osseous or cartilaginous neoplasm
If we are talking about osteoarthritis as opposed to RA, in what direction would we expect to see the remodeling progressing
Once the condylar head has flattened enough, what anatomic feature will be visible?
Osteophyte, aka bone spur
How will subchondral cysts show up on the image
small ovoid RLs just beneath the cortical rim
Where might sclerosis be found in an osteoarthritic TMJ
On the condylar head and/or the temporal bone
What is it called when an osteophyte breaks loose
How do you treat osteoarthritis patients with no pain?
With pain you give them a condylar shave procedure
What is the condylar fovea
Large ovoid RL on the medial aspect of condyle
Not all patients have this
Just means that the bone is thinner here and attenuated less radiation
What direction is more common for bifid condyles
What section of the mandible do we look at after the condylar head?
Cortical border starting by moving down the right ramus around the inferior border, and up to the left condyle looking for fractures
What is the first thing you need to determine if you see a jaw fracture?
For the first 4-6 weeks post-fractures what can you see
Only the RL fracture line
5-6 weeks post fracture what can you see
Fuzzy organic callus RP superimposed over the fracture line