More radiographic interpretation Flashcards
Give a few examples of uncommon things to be seen on a radiograph?
- jaw lesions such as cysts or tumours
- Supernumeraries
- Foreign bodies
When describing a lesion what are 7 key features you need to include?
- Site
- Size
- Shape
- Margins
- Internal structure
- Effect on adjacent anatomy
- Number
When describing the SITE of a lesion what do you need to include?
- Where is it?
- Is there a notable relationship to another structure ? i.e. teeth , IANm nasopalatine canal
- Where is it’s position relative to particular structures i.e. IANC , maxillary sinus floor
If a lesion is found entirely above the maxillary sinus is this likely to be odontogenic?
- Highly unlikely to be odontogenic
If a lesion is found below the IANC is it likely to be odontogenic?
- Highly unlikely to be odontogenic
When describing the size of a lesion how can you describe it?
- Measure or estimate the dimensions i.e. 50mm mesio-distally or 35mm supero-inferiorly
- Or Describe the boundaries i.e. extends between teeth 34 and 38 from the alveolar crest to the inferior cortical margin of the mandible
How would you describe the shape of a lesion?
Give the general shape
- Rounded
- Scalloped
- Irregular
Give the Locularity
- Unilocular
- Pseudolocular
- Multilocular
How would you describe the margins of a lesion on a radiograph?
Well defined and either
- Corticated *
- Non -corticated *
* NA to radiopacities
Poorly defined and
- blending into adjacent normal anatomy
- Ragged or moth eaten
What does a corticated lesion suggest ?
- benign lesion
What does a moth eaten margin suggest?
- Malignancy
How would you describe the internal structure of a radiographic lesion?
Is it
- Entirely radiolucent
- Radiolucent with some internal radiopacity
- Radiopaque (homegeneous or heterogeneous)
Describe the internal radiopacities
- Amount of them (Scant, multiple, dispersed)
- Any Bony septae (Thin/course, prominent/faint, straight/curved)
- Any partiuclar structure like enamel or dentine radiodensity
What makes a jaw lesion radiolucent?
- Resorption of bone
- Decreased mineralisation of bone
- Decreased thickness of bone
- Replacement of bone with abnormal less mineralised tissue
What makes a jaw lesion radiopaque?
- Increased thickness of bone
- Osteosclerosis of bone
- Presence of abnormal tissues
- Mineralisation of normally non-mineralised tissues
If there is involvement of tooth in a lesion how might you describe this?
- Around apex/apices
- At side of root
- Around crown
- Around entire tooth
Why is noting the lesions effect on adjacent anatomy important?
- Can indicate nature of lesions and aid diagnosis
- Aggressive pathologies tend to grow quickly and be more destructive
If a lesion is present in the jaw how may this affect the teeth as an adjacent structure?
- Displacement/impaction
- Resorption
- Loss of lamina dura
- Widening of PDL space
- Hypercementosis
What is Hypercementosis?
- Non neoplastic condition characterised by excessive build up of normal cementum on the roots of one or more teeth
- Asymptomatic
- Cause unknown but can be seen with Paget’s disease of bone and acromegaly
- Makes XLA harder
If a lesion is present in the jaw how may this affect the bone as an adjacent structure?
- Displacement of cortices
- Perforation of cortices
- Sclerosis of trabecular bone
If a lesion is present in the jaw how may this affect the IAC, maxillary sinus, nasal cavity as an adjacent structure?
- Displacement
- Erosion
- Compression
The number of lesions can aid diagnosis. What may you suspect for single, bilateral or multiple lesions?
- Majority of lesions occur alone
- Few pathologies can occur bilaterally
- Suspect a syndrome if multiple >2 lesions
Please describe this lesion
Site : in alveolar bone in 46 region,
above the right inferior alveolar canal
* Size: 10mm mesio-distally by 12mm
supero-inferiorly in maximum dimensions
* Shape: unilocular & rounded
* Margins: well-defined & corticated
* Internal structure: entirely radiolucent
* Tooth involvement: no (note: close to
45 but there is intervening bone)
* Effects: none visible
* Number: single
Please describe this lesion
Site: in right ramus & posterior body of
mandible; above the right inferior
alveolar canal
* Size: 35mm mesio-distally by 70mm
supero-inferiorly in maximum dimensions
* Shape: pseudolocular & scalloped
* Margins: well-defined & corticated
* Internal structure: entirely radiolucent
* Tooth involvement: yes, involves
occlusal surface of 48
* Effects: displaced 48; displaced 47;
displaced IAC; displaced & thinned
inferior cortex of mandible (note: no
resorption of teeth)
* Number: single
Please describe this lesion
Site: in alveolar bone in 46 region,
above the right inferior alveolar canal
* Size: full height of alveolar bone &
similar width of molar
* Shape: oblong but irregular
* Margins: well-defined & smooth
* Internal structure: homogeneously
radiopaque
* Tooth involvement: yes, involves the
furcation & apices of 46
* Effects: none – tooth is not
displaced/resorbed & PDL space
remains
* Number: single
A periapical radiolucency has multiple potential causes. Give some examples
- Periapical granuloma
- Periapical abscess
- Radicular cyst
- “Perio-endo” lesion
- Cemento-osseous dysplasia (in early stage)
- Surgical defect (following peri-radicular surgery)
- Fibrous healing defect (following resolution of lesion)
- Ameloblastoma occurring next to tooth
