[Oradlist] cbct images of 23 year old patient

[Lennart Flygare]

Dear Marta and Leif,

In multifocal osteomyelitis like in CRMO or in SAPHO,  pain and parestesia doesn't have to be a prominent feature and may be absent even in view of pronounced radiographic findings. Osteomyelitis would still be my first hand diagnosis with malignancy as differential.
I am looking forward to hear of the final diagnosis.

Merry Xmas

Lennart :)
-------------------------------------
Lennart Flygare, Odont Dr
Senior Consultant
Dentomaxillofacial Radiology
Dept of Radiology
Sunderby Hospital
SE-971 80 Luleå
SWEDEN

tel+46-920-282931
mob: +46-70-6743858
fax:+46-920-282942
P  Think of the environment before printing this e-mail.
________________________________
Från: oradlist-bounces at lists.ucla.edu [mailto:oradlist-bounces at lists.ucla.edu] För Leif Kullman
Skickat: den 21 december 2009 21:15
Till: Oral Radiology Discussion Group
Ämne: Re: [Oradlist] cbct images of 23 year old patient

Dear Marta, yes the pictures are better now, but I think you could compress even less in the future if you send cases.

If the patient has for example an acute osteomyelitis, which could be probable considering the history with earlier antibiotics prescription, then he should have had pain and perhaps paresthesia of the lip. Also a feeling of general illness and fever. Do you know if any of these symptoms have been present?

Another differential diagnosis which comes to my mind is multiple myeloma. If you suspect this, you could try to take a skull radiograph, since cranial lesions seem to be common in this disorder.

Best regards and Merry Xmas          Leif

Leif Kullman DDS, PhD
Assoc. Professor
Oral and Maxillofacial Radiology
Faculty of Dentistry
Kuwait University

--- On Mon, 12/21/09, dyszki at poczta.onet.pl <dyszki at poczta.onet.pl> wrote:

From: dyszki at poczta.onet.pl <dyszki at poczta.onet.pl>
Subject: [Oradlist] cbct images of 23 year old patient
To: oradlist at lists.ucla.edu
Date: Monday, December 21, 2009, 12:27 PM

I am sorry for the low resolution, I must have compressed them too much.
I am enclosing better quality images in this email.
Refering to his treatment, he was diagnosed in the end of September with mandible abcess. .He had panoramic image taken , did not show any pathology. He was treated then with antibiotics.He felt improvement. But the cause of it was still not revealed.Later on he was refferd to a periodontist and that is how he ended up at our school -it was on Thursday last week. He had two intraoral x ray taken and at the region of premolars there was significant lesion present. And finally he was send for cbct examination.The patient doesn't suffer from any other diseases , at leat it did not come up in the medical history.
We reffered him to maxillofacial surgeon for further treatment , I will know more on his blood test on Wednesday , but unfortunately for the histopatologic examination we would have to wait at least 10 days.
I will keep You updated on our progress , we stay in touch with the maxillofacial dep. and the patient.
Thank You for all the comments.
Marta

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