Head and Neck Radiology Flashcards
RECAP- which types of radiology don’t involve any radiation?
Ultrasound
MRI
What might plain radiography (x-rays) be used to visualise in head and neck?
Maxillofacial views
OTP (Dental assessment).
What is the anatomical barrier between the oropharynx and the oral cavity?
Anterior pillars of tonsillar fossa
Where is the most common place for a foreign body to end up if entry via mouth e.g. fish bone?
Pyriform sinuses
Name the type of x-ray used on the lower face, teeth and jaw.
OTP
Which materials are usually used for contrast studies?
Barium and iodine based water soluble contrast swallows
What is a common factor of the contrast swallows?
They’re radiopaque and can show structure of parts of ther body you might not usually see
What is FOSIT?
Feeling Of Something In Throat
(first letter of each word = FOSIT)
How is the complaint of FOSIT investigated?
Often using flexible nasoendoscopy
Which material is okay when used in contrast studies in the GIT but not okay when outside the GIT?
Barium
What are sialograms used for?
Using a contrast medium to assess ducts within a salivary gland
Name an abnormality that can be picked up in the salivary glands when using sialogram.
Punctate sialectasis- looks like lots of little dots
Which condition is punctate sialectasis associated with?
Sjogren’s syndrome
What is the presentation of Sjogren’s syndrome?
Dry mouth, dry eyes, pain in joints (athralgia), abnormal salivary ducts
What is videofluroscopy useful for?
Assessing function of someone’s swallowing.
Which other healthcare specialist will be present when doing a videofluroscopy?
Speech therapist
When may someone’s normal swallowing mechanism become abnormal?
After stroke
Post-op
After a laryngectomy, it is a lot more difficult to speak and patients can use oesophageal speech. However, it is a lot quieter than normal speech. Name one way oesophageal speech can be enhanced.
Insertion of a Blom-Singer valve
List some of the advantages of Ultrasound.
No radiation
Portable
Safe
Which type of structure is ultrasound good for?
Soft tissues, or if anything has fluid in it when it shouldn’t
Not good for bone or gas-filled areas like bowels
What type of ultrasound is used to look at vascularity?
Doppler ultrasound
When else may ultrasound be used?
To guide fine needle aspirations
To characterise lymph nodes
Investigation of hyperparathyroidism
What tests would be done if you suspect your patient has primary hyperparathyroidism?
Check calcium levels
If raised, check serum parathormone level.
What would a patient with primary hyperparathyroidism present with?
‘Stones, moans, bones and groans’
General aches, kidney stones, etc.
What is a sestamibi scan?
Nuclear medicine scan, used to evaluate function of parathyroid glands
What is the substance and the radioisotope used in sestamibi scanning?
Sestamibi= substance
Radioisotope= technecium-99
How is the outer ear best assessed?
Otoscopy
How is the middle ear best assessed?
CT (lots of bony structures)
How in the inner ear best assessed?
MRI (soft tissue)
What type of radiology will show up sinuses of the brain well?
CT
If a subperiosteal collection is seen on radiology, what needs to be done?
Pus has leaked from ethmoid sinus into lamina papyracea to form a subperiosteal abscess.
Needs to be surgically treated or could cause blindness due to stretching of the optic nerve.
Upon radiography, you see a tumour sitting in the carotid bifurcation. Which type of tumour is this very likely to be?
Carotid body tumour
What is important to consider when investigating a carotid body tumour?
10% of these tumours are bilateral so always important to check the other side
Which contrast is most commonly used in MRI?
Gadolinium
Who cannot have an MRI?
Those with metal replacements or any metal within or on them at all.
Those who are claustrophobic.
What is the ideal imaging modality for the assessment of temporomandibular joints?
MRI
Describe what happens in PET scanning.
Use of radioisotope which emits positrons, often taken up by cancer cells
If a PET scan shows an area which has taken up a lot more of the contrast, it doesn’t automatically mean it’s cancer. What else may it be?
Area of infection/inflammation
