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Radiology · patient case question

A panoramic radiograph in a patient with Eagle syndrome would show what?

Patient case: Radiographic findings, prosthodontic planning and periodontal diagnosis

Scenario: Five items.

  1. An elongated coronoid process
  2. A calcified submandibular sialolith
  3. A calcified carotid atheroma at the level of C3-C4
  4. An elongated styloid process or mineralised stylohyoid ligament
Show answer and explanation

Correct answer: D. An elongated styloid process or mineralised stylohyoid ligament

  • A. Coronoid hyperplasia limits opening through impingement on the zygoma — a different entity.
  • B. A submandibular stone is a discrete radiopacity in the floor of the mouth or gland, better shown on an occlusal film.
  • C. Carotid calcifications appear as vertical radiopacities adjacent to the cervical vertebrae. They are an important incidental finding warranting medical referral, but they are unrelated to Eagle syndrome.
  • D. Correct. Eagle syndrome is elongation of the styloid process or ossification of the stylohyoid ligament, producing throat pain, dysphagia and pain on turning the head — symptoms easily mistaken for a dental or TMJ complaint.

Note: The normal styloid process is roughly 25 mm. Beyond about 30 mm it is considered elongated, though many elongated processes are entirely asymptomatic.

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