WIDI - CA0154-Dental Infection with Localized Subperiosteal Abscess, CT

Dental Infection with Localized Subperiosteal Abscess, CT

Claim CME Credit

0.5 CME Credit available on completion

POINT OF CARE INFORMATION

This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.

Learning Objectives

As a result of participation in this activity, participants should be able to:

Provide improved patient care.
Greater knowledge of the imaging characteristics of the patient's disease.
Understand a better approach to interpretation of studies.

Faculty Disclosure

Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.

CME Advisory Committee Disclosure:

Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.

Continuing Medical Education Credit

Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CA0154-Dental Infection with Localized Subperiosteal Abscess, CT

History

15-year old female with fever and facial swelling due to possible dental infection.

Exam

Contrast-enhanced CT of the maxillofacial region and neck and related anatomy with images obtained in the balanced or venous vascular phase to ensure optimal visualization of both arterial and venous structures as well as possible reactive changes around infected collections. 0.5-3.0 mm thick sections were obtained in the axial plane and reformatted 3D and/or in the coronal and sagittal planes and viewed inter actively in 3 dimensions at the computer work station.

Prior Study

N/A

Findings

Oral cavity, floor of the mouth, maxilla and mandible

There is cellulitis involving the soft tissues of the face, and buccal space laterally as well as the floor of the mouth on the left side. There is also evidence of cellulitis in the submandibular space. This appears to be due to disease from an extracted left lower 1st molar adjacent to which there is a small subperiosteal abscess. The bone of lingual plate in the area of this abscess is thin but not obviously dehiscent.

Oropharynx and Nasopharynx

There is no significant abnormality involving the oropharynx or nasopharynx.

Retropharyngeal and Cervical Lymph Nodes:

There is reactive cervical lymphadenopathy in level 1 on both sides and in level 2 on the left. There is no suppurative cervical lymphadenopathy.

Vascular findings

No related significant vascular abnormalities are identified

Other findings:

There is no significant airway encroachment.

Impression

There is cellulitis and a very localized subperiosteal abscess associated with an extracted left lower 1st molar. Please see above discussion.

Recommendations

The emergency medical service was promptly and verbally notified, even though routine communication for the emergency medical service would have sufficed, of these findings and consulted the oral maxillofacial surgery service to help manage the patient while in the emergency room.