TOPIC: SOFT-TISSUE CALCIFICATION
🌟 IMPORTANT POINTS TO REMEMBER
🔹Antroliths: It is the term used to describe calculus located in the paranasal sinuses. Majority of patients present clinical signs and symptoms, such as facial pain, nasal stuffiness and obstruction, and purulent, blood-stained or foul-smelling discharge. They have well-defined periphery with smooth or irregular shape.
🔹Calcified Carotid Artery Atheromas: Atheromas are fibrous, fatty plaques located in the intima of arteries. Carotid bifurcation atheroma is an important cause of stroke, or low-flow-related mechanisms. The atheroma may appear either as a nodular radio-opaque mass or as two radio-opaque vertical lines within the soft tissues of the neck at the level of the lower margin of the third cervical vertebra.
🔹Calcified Lymph Nodes: Submental, submandibular and cervical and digastric lymph nodes are usually enlarged. Multiple radio-opaque areas distributed along the affected lymphatic chains may be observed in the radiographic examination. Sometimes, irregular heterogeneous opaque masses are seen which appear to resemble a mass of coral.
🔹Phleboliths: Phleboliths are venous calcifications which, in the majority of cases, are observed in thrombosed veins. The involved soft tissue may be swollen or discoloured by the presence of venous or a soft-tissue haemangioma.
🔹Phleboliths are generally seen as multiple radio-opacities, round or ovoid-shaped, and their size varies from a few millimetres to 1 cm. An onion ring appearance is present.
🔹Mineralisation Of Stylohyoid /Stylomandibular Complex: When ossification of stylohyoid is associated with discomfort, it is called as ‘Eagle syndrome’. The Eagle syndrome is classically categorised by constant pain or discomfort in the pharynx. The styloid process appears as a long, lapping, thin, radio-opaque process between the ramus of the mandible and the mastoid process.
🔹Rhinoliths: Rhinoliths are generally irregular calculus concretions, formed in the nasal cavity around a nucleus of endogenous origin. They have a coraliform appearance. Radiographic features of rhinoliths usually show dense radio opacities in the anterior maxillary region.
🔹Sialoliths In Submandibular, Sublingual And Parotid Glands: Sialolithiasis is defined as a formation of calcified concretions within the parenchyma or system of ducts of a major and/or minor salivary gland. Oedema and pain as well as infection in the gland may be present. Hardly calcified salivary calculus (radiolucent calculus) may not be observed in standard or low-density radiographs.
🔹Tonsilloliths: Tonsilloliths or tonsillar calculi are small calcifications commonly found in tonsillar or adenoidal crypts. The tonsilloliths may be seen as a white or yellowish hard object within the tonsillar crypt. It can produce ‘speckled’ appearance of multiple radio-opaque structures superimposed bilaterally on the images of the mandibular rami in a panoramic radiograph.
🔹Cutaneous Calcification And Ossification: In calcifications, there is insoluble calcium salt deposition; when in the face, they are called ‘calcinosis cutis’.
🔹Dystrophic Calcification: It is subdivided into calcinosis circumscripta (few calcium salt deposits) and calcinosis universalis (large and widespread deposits).
🔹Metastatic Calcification: The calcium is deposited in normal tissues, as a result of abnormalities in calcium and/or phosphate metabolism that leads to hypercalcaemia or hyperphosphataemia.
🔹Idiopathic Calcification: Idiopathic calcification occurs without any evidence of tissue alterations or alterations in calcium and/or phosphate metabolism.
🔹Iatrogenic Calcification: There are reports of calcifications related to extravasation of calcium solution as a complication of intravenous calcium chloride or also of prolonged contact with saturated calcium chloride electrode paste.
🔹Ossifications: Multiple miliary osteoma cutis of the face represents a rare and frequently unrecognised complication of chronic inflammatory acne. Radiographically, multiple miliary osteoma cutis of the face appears as a small doughnut-shaped image, with a radiolucent centre representing the central bone marrow cavity.
📌 MULTIPLE CHOICE QUESTIONS MCQs
💡 Calculus located in the maxillary sinuses can be termed as
- Sinolith
- Antrolith
- Rhinolith
- All of the above
Answer: 4
💡 Antrolith can originate
- Endogenously
- Exogenously
- Both a and b
- None of the above
Answer: 3
💡 Fibrous, fatty plaques located in the intima of arteries are termed as
- Fibroma
- Papilloma
- Atheroma
- Lipoma
Answer: 3
💡 Radiographic appearance of lymph node calcification can be like
- Cauliflower
- Mass of coral
- Any of the above
- None of the above
Answer: 3
💡 Term given to venous calcification is
- Venolith
- Arteriloith
- Phlebolith
- Both a and b
Answer: 3
💡 A typical feature of phlebolith, i.e. external calcification with radiolucency in the central portion is termed as
- Earring appearance
- Onion ring appearance
- Any of the above
- Bolt appearance
Answer: 2
💡 The approximate normal length of the styloid process should be
- 15 mm
- 25 mm
- 15 in.
- 25 in.
Answer: 2
💡 The ossification of the stylohyoid complex may be associated with discomfort; it is termed as
- Kite syndrome
- Eagle syndrome
- Sjögren syndrome
- None of the above
Answer: 2
💡 Irregular calculus mass formed in the nasal cavity is termed as
- Rhinolith
- Nasolith
- Both of the above
- None of the above
Answer: 1
💡 Insoluble calcium salt deposition in the face is known as
- Calcinosis cutis
- Calcinosis dermis
- Cutiolith
- Dermolith
Answer: 1