E4990. Make Your Jaw Drop: A Pictorial Review of Mandibular Pathology
Authors
Andrew Ragheb;
Corewell Health William Beaumont University Hospital
Abdul-Majid Khan;
Corewell Health William Beaumont University Hospital
Sailaja Yadavalli;
Corewell Health William Beaumont University Hospital
Background
As the only movable bone in the skull, the mandible is essential for multiple activities of daily living, such as speech and eating. Therefore, mandibular pathology can be extremely debilitating to patients. Understanding the complex anatomy of the mandible and knowledge of possible mandibular lesions is critical for the radiologist in order to direct appropriate imaging, establish correct diagnoses, and guide treatment recommendations.
Educational Goals / Teaching Points
This presentation will briefly review normal mandibular anatomy, followed by a discussion of various cases of mandibular pathology including but not limited to congenital, traumatic, infectious, metabolic, and neoplastic etiologies, as well as their mimics. Our aim is to highlight key imaging characteristics and anatomic relationships that would assist in accurate differentiation and diagnosis. The exhibit will also discuss some rare entities that should be considered in the differential diagnosis.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Radiographs are usually the first-line imaging modality for suspected mandibular pathology. However, the curved morphology of the mandible and overlying structures often limit evaluation and require further imaging with CT or MRI, or both. Cross-sectional imaging has its own limitations, as the mandible is seen only piecemeal on sequential images and artifacts from dental implants present challenges during evaluation. Additional imaging techniques such as PET or radionuclide scintigraphy and 3D imaging may be of benefit in reaching a correct diagnosis. When appropriate, cases will include discussion of optimal imaging modalities.
Conclusion
Mandibular pathology is relatively uncommon in everyday practice and a missed or delayed diagnosis of a lesion may result in serious morbidity to a patient. A thorough understanding of mandibular processes and their key imaging features is essential for the radiologist to direct appropriate imaging and improve patient care.
