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Radiology Quiz Case

Radiology Quiz Case A 66-year-old man with multiple myeloma presented with a 6-month history of swelling and pain in the edentulous right premolar mandibular region. He reported that he had undergone 1 tooth (premolar) extraction 1 year earlier and 2 unsuccessful alveolar debridements after the extraction in another center. One year before presentation, he had been treated monthly with intravenous zoledronate (Zometa) infusions, at a dose of 4 mg, over a period of 15 minutes (17 sessions). Intraoral examination revealed a painful moderate expansion of the alveolar bone at the surgical site. The surrounding soft tissue was erythematous and edematous (Figure 1). Panoramic radiography (Figure 2) and computed tomography with multiplanar reconstruction of the jaws (DentaScan) revealed a bone sequestrum in the right mandibular region (Figure 3and Figure 4). Conservative treatment with a combination of oral antibiotics (amoxicillin–clavulanate potassium) and chlorhexidine mouthwash was initiated. After 2 weeks, another intraoral examination showed that no progress had been made in wound healing at the site. Minimal sequestrectomy was subsequently performed with the patient under local anesthesia. Figure 1. View LargeDownload Figure 2. View LargeDownload Figure 3. View LargeDownload Figure 4. View LargeDownload What is your diagnosis? http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

Radiology Quiz Case

Abstract

A 66-year-old man with multiple myeloma presented with a 6-month history of swelling and pain in the edentulous right premolar mandibular region. He reported that he had undergone 1 tooth (premolar) extraction 1 year earlier and 2 unsuccessful alveolar debridements after the extraction in another center. One year before presentation, he had been treated monthly with intravenous zoledronate (Zometa) infusions, at a dose of 4 mg, over a period of 15 minutes (17 sessions). Intraoral examination...
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Publisher
American Medical Association
Copyright
Copyright © 2008 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.134.11.1229
Publisher site
See Article on Publisher Site

Abstract

A 66-year-old man with multiple myeloma presented with a 6-month history of swelling and pain in the edentulous right premolar mandibular region. He reported that he had undergone 1 tooth (premolar) extraction 1 year earlier and 2 unsuccessful alveolar debridements after the extraction in another center. One year before presentation, he had been treated monthly with intravenous zoledronate (Zometa) infusions, at a dose of 4 mg, over a period of 15 minutes (17 sessions). Intraoral examination revealed a painful moderate expansion of the alveolar bone at the surgical site. The surrounding soft tissue was erythematous and edematous (Figure 1). Panoramic radiography (Figure 2) and computed tomography with multiplanar reconstruction of the jaws (DentaScan) revealed a bone sequestrum in the right mandibular region (Figure 3and Figure 4). Conservative treatment with a combination of oral antibiotics (amoxicillin–clavulanate potassium) and chlorhexidine mouthwash was initiated. After 2 weeks, another intraoral examination showed that no progress had been made in wound healing at the site. Minimal sequestrectomy was subsequently performed with the patient under local anesthesia. Figure 1. View LargeDownload Figure 2. View LargeDownload Figure 3. View LargeDownload Figure 4. View LargeDownload What is your diagnosis?

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: Nov 17, 2008

Keywords: diagnostic radiologic examination,radiology specialty

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