A patient reports sharp pain on head turning, on mouth opening, and during swallowing. Which radiograph is most appropriate for initial evaluation?

Correct answer: B. Panoramic (OPG)

• A. ❌ Periapical films are limited to individual teeth and cannot visualize the styloid or TMJ region.
• B. ✅ Correct. The triad of pain on head rotation, mouth opening, and swallowing is characteristic of Eagle syndrome (elongated styloid process). The panoramic radiograph is the most appropriate initial imaging — it visualizes the styloid process and surrounding structures.
• C. ❌ Occlusal films show the floor of mouth and palate — not appropriate for this presentation.
• D. ❌ Lateral cephalometric shows the craniofacial skeleton but is not the first choice for styloid evaluation.