10. Soft Tissue Calcifications Flashcards
What are the 3 tissue types of disorganised heterotropic calcification?
- Dystrophic
- Idiopathic
- Metastatic
In which type of disorganised heterotropic calcification is serum calcium phosphate elevated?
Metastatic heterotropic calcification
- due to systemic conditions
What are some soft tissue calcifications of dystrophic type?
- Tonsillolith
- Calcified carotid artery plaques
- Calcified lymph nodes
What are some soft tissue calcifications of Idiopathic type?
- Triticeous cartilage
- Phlebolith
- Sialoliths
- Rhinoliths & Antroliths
What are some soft tissue calcifications of Metastatic type?
Systemic conditions
E.g.
1. Hyper parathyroidism
2. Hypercalcemia
3. Renal failure
What are some heterotropic ossifications of organised bone type?
- Ossification of stylohyoid ligament
- Osteoma cutis
- Myositis ossificans
What are the locations at which soft tissue calcifications should be looked out for?
- Ramus
- Soft tissues of neck - ramus to hyoid
- Soft tissues of neck - below hyoid
- Sinus & Nasal cavity
- Cheek & lips
- Osteoma cutis
- Submandibular region
What soft tissue calcifications are commonly found at the ramus?
- Tonsilloliths
- Parotid gland sialoliths (super super rare)
What soft tissue calcifications are commonly found at the neck area, below the hyoid?
- Triticeous cartilage
- Thyroid cartilage
What soft tissue calcifications are commonly found at the neck, from hyoid to ramus?
- Ossified stylohyoid ligament
- Calcified atheromatous plaque
- Calcified lymph nodes
- Phleboliths
What soft tissue calcifications are commonly found at the Sinus & Nasal cavity?
Rhinoliths and Antroliths
What soft tissue calcifications are commonly found at the cheek & lips?
Osteoma cutis
What soft tissue calcifications are commonly found at the Submandibular gland region?
Submandibular gland sialoliths
Which is the most common soft tissue calcification?
Tonsilloliths
How do tonsilloliths present on the radiograph?
- at ramus
- small & clustered, ill defined, irregular
- can be round or jagged
How does the Tonsillolith come about?
Accumulation of debris (bacteria, pus, epithelial cells, food) in the setting of inflammation within the tonsillar crypts
- serves as nidus of dystrophic calcification
What is the most common sialolith? Why?
Submandibular gland sialolith. (>85%)
- wharton’s duct is long & tortuous, travels against gravity
- saliva from SMG is also more viscous/mucus
Meal time symptoms are a sign of what soft tissue calcification?
Sialoliths
- increased discomfort arises when salivary flow is stimulated
How do sialoliths present on radiograph?
- Heavy chunck of calcification
- smooth outline
- ovoid or cylindrical
- can be homogenously radiopaque or lamellated
- near SMG usually - Diffuse & disperse (sjogren’s syndrome) (dry eyes n dry mouth)
What is Lithotripsy?
- use of shock waves to break up stone (b4 milking stone out), when stone is too big
Where is the triticeous cartilage located?
- in the straight line, below end of hyoid bone and above thyroid cartilage
- smooth, well defined, rounded radio-opacity ‘grain of wheat’
What is Eagle’s syndrome?
- stylohyoid syndrome (calcification)
- characterised by sharp pain at throat to neck, radiating through ear
- esp when chewing, swallowing, speaking, yawning
How does ossification of the stylohyoid ligament appear on radiographs?
- linear, straight ossification (w bone-like density)
- extends from mastoid region towards hyoid bone
