Craniofacial Imaging

Question 1

This patient presents with fever, nasal congestion and facial tenderness - suggest what the pathology is?

Answer 1

Fluid into the left maxillary sinus, thickening of the ethmoidal sinus
Indicates sinusitis.

Question 2

What are some common complications of sinusitis?

Answer 2

Filling defects
Abscess

Question 3

A patient presents with fever and ear pain. Suggest the diagnosis.

Answer 3

Left mastoid air cells and external acoustic meatus - increases pacification
Mastoiditis

Question 4

This patient was punched in the face - was are the relevant imaging findings?

Answer 4

Infraorbital swelling
Orbit protrusion
Post-orbital bleeding
Opacity in the maxillary sinus
Comminuted fracture involving the infraorbital wall

Question 5

Patient presents with sensorineural hearing loss - refer to imaging what is the relevant findings?

Answer 5

Right pontine cerebellar mass
Schwannoma
Mild mass effect to the pons and fourth ventricle.

Question 6

What are the different lines that can be drawn on a normal sagittal image of the spine?

Answer 6

Anterior vertebral line - unify an vertebral bodies
posterior vertebral line - unify psoterior vertebral bodies
Posterior spinous line (orange) - unify spinous process
Spinolacrimal line- transverse process

Question 7

What is the normal prevertebral thickness on imaging and what does this mean?

Answer 7

<7mm at C2
<22mm at C7
This is the distance of soft tissue in front of the anterior vertebral body.

Question 8

What is seen on this imaging tool?

Answer 8

C2 - fracture
Note C1 is not fractured as no lateral displacement of the vertebral bodies.

Question 9

How to tell the difference between a coin and a battery on imaging?

Answer 9

Coin - all same colour
Battery - double ring or halo sign

Question 10

What is the Steeple sign on imaging of the neck?

Answer 10

Narrowed airway in the cervical spine regions - commonly indicates an upper respiratory tract infections - glossitis.

Question 11

Where do most aneurysms form in the brain arterial circulation?

Answer 11

Anterior communicating artery.

Question 12

Patient presents with pain during eating - what are you worried about?

Answer 12

Submandibular salivary gland stone

Question 13

What is a sialogram?

Answer 13

Imaging of the salivary gland
Give lemon juice etc - to open the salivary gland
Administer contrast - then imaging for filling defects - allows to detect stones in the salivary gland.