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Case 93008

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Referral category

Disease / syndrome / tumor / condition

Region of interest

Q3 and Q4

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Canaray 93008

1. Melorheostosis of the left posterior mandible

The left posterior mandible, ramus, and condyle exhibit cortical thickening, sclerosis within the cancellous bone, and generalized enlargement. The cortical bone remains intact, and there is no evidence of osseous sequestration or a periosteal reaction. The left mandibular nerve canal exhibits a normal course and caliber. No significant tooth displacement is noted.

These radiographic findings are consistent with a monostotic sclerosing bone dysplasia. The presence of both cortical and intramedullary sclerosis and mandibular enlargement in conjunction with purported left-sided pain suggests melorheostosis is the most likely diagnosis.

Mesiodistal views of posterior 3rd quadrant

These mesiodistal cross-sectional images demonstrate extensive sclerosis involving the intramedullary component of the left posterior mandible and ramus. The cancellous bone of the left condylar head has been nearly completely replaced by high-density, sclerotic bone. Note the normal appearance of the left mandibular nerve canal.

Axial views of mandible

These axial cross-sectional images demonstrate enlargement of the left posterior mandible, ramus, and condylar head compared to the right side. Thickening of the cortical bone is evident. No signs of a periosteal reaction are present.

Coronal views of mandible

These coronal cross-sectional images demonstrate thickening of the buccal and lingual cortices of the left posterior mandible and ramus, as well as extensive sclerosis involving the trabecular bone. There is no indication of an inflammatory etiology of this mandibular enlargement.

2. External resorption on tooth 37M

A localized area of external resorption is present on the distolingual surface of the apical half of the mesial root of tooth 37. Tooth 37 appears normal otherwise. This resorptive defect should be monitored for potential progression.

3. Calcified stylohyoid ligaments

The stylohyoid ligaments are partially calcified bilaterally. This is an incidental finding with no clinical significance.