WIDI - CA0155-Dental Infection, Cellulitis, No Abscess, CT

Dental Infection, Cellulitis, No Abscess, CT

Claim CME Credit

0.5 CME Credit available on completion

POINT OF CARE INFORMATION

This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.

Learning Objectives

As a result of participation in this activity, participants should be able to:

Provide improved patient care.
Greater knowledge of the imaging characteristics of the patient's disease.
Understand a better approach to interpretation of studies.

Faculty Disclosure

Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.

CME Advisory Committee Disclosure:

Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.

Continuing Medical Education Credit

Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CA0155-Dental Infection, Cellulitis, No Abscess, CT

History

46-year old female with facial swelling and suspected odontogenic

Exam

Contrast-enhanced CT of the maxillofacial region and neck and related anatomy with images obtained in the balanced or venous vascular phase to ensure optimal visualization of both arterial and venous structures as well as possible reactive changes around infected collections. 0.5-3.0 mm thick sections were obtained in the axial plane and reformatted 3D and/or in the coronal and sagittal planes and viewed inter actively in 3 dimensions at the computer work station.

Prior Study

N/A

Findings

Oral cavity, floor of the mouth, maxilla and mandible

There is likely cellulitis of the palatine and buccal mucosa of the right maxilla with edema and possibly cellulitis in the surrounding buccal space and the adjacent SMAS. The masticator space, floor of the mouth and submandibular space appear normal. There is a edema along the palatine plate of the maxilla adjacent to the last three molars.

There is likely minimal edema within the fat of the adjacent parapharyngeal space on the right.

There is significant periapical and endodontal disease at the level of the three molars in the right maxilla with a defect in both the palatine and buccal cortical plate.

Cervical and Retropharyngeal Lymph Nodes:

There is reactive cervical lymphadenopathy in level 1 and 2 on the right. There is no suppurative cervical lymphadenopathy.

Major Salivary Glands

There is no significant abnormality of the parotid, submandibular or sublingual glands that would be an alternative explanation for the patient’s symptoms.

Vascular findings

There is no evidence of thrombus, thrombophlebitis or other occlusive or inflammatory process of the visualized vascular structures.

Other findings:

There is a thyroid nodule (9mm) in the right lobe. Ultrasound follow-up is not recommended in this age group for a nodule of this size without evidence of aggressive behavior.