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Case 103198

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Referral category

Disease / syndrome / tumor / condition

Region of interest

right inferior border of mandible, beneath 43-46

Referral reason

[Only visible to logged-in users]

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Canaray 103198

1. Mandibular asymmetry secondary to fibrous dysplasia

A localized zone of fibrous dysplasia is present in the anterior right mandible. This fibrous dysplasia has produced a localized region of asymmetry at the inferior mandibular border. Internally, the entity is composed of dysplastic bone with a heterogeneous "cotton-wool" appearance. The density of the bone in this region is higher than that of the adjacent trabecular bone. The buccal and lingual cortical plates have been thinned, and are being replaced with dysplastic bone. The dentition in the fourth quadrant is normal radiographically. The surrounding structures appear normal otherwise.

Axial views of mandibular arch

These axial cross-sectional images demonstrate the heterogeneous appearance of the bone in the anterior right mandible. The mild expansion of the mandible in the region of bone dysplasia is evident in these images, as is the absence of any effect upon the dentition in the fourth quadrant.

High-resolution images of anterior left mandible

A small field scan captured in the region of bone dysplasia at high-resolution. The heterogeneous appearance of the internal structure of the bone is evident in these images, as is the continuity of the periphery of the entity with the adjacent normal trabecular bone. The loop of the right mental foramen has been slightly displaced, but the nerve canal appears normal otherwise.

Axial views of anterior fourth quadrant

These axial cross-sectional images demonstrate the alteration in the path of the right inferior alveolar nerve canal in the region of the right mental foramen. The inferior alveolar nerve canal does not exhibit any reduction in diameter adjacent to the dysplastic bone. The extension of the dysplastic bone into the buccal and lingual cortical plates is evident in these images.

Mesiodistal views of mid-fourth quadrant

These mesiodistal cross-sectional cross sectional images demonstrate the epicenter of the fibrous dysplasia in the inferior half of the right mandibular body in the region apical to teeth 43, 44, and 45.

Buccolingual views of mid-fourth quadrant

These buccolingual cross sectional images demonstrate the widened buccolingual dimensions of the alveolar process in the region of bone dysplasia in the mid-fourth quadrant. Note the normal appearance of the bone surrounding the roots of the teeth in the region.

2. Pneumatocyst in C4

A gas-filled cavity is present on the inferior aspect of the right lateral articulating facet of the fourth cervical vertebra. This represents a pneumatocyst, which is a sign of cervical degenerative joint disease. Other findings that support this diagnosis are the reduced articulating spaces, and the presence of subchondral sclerosis and osteophytes on the articulating surfaces of the vertebrae.