Head and Neck

This category contains 22 posts

Sinonasal Osteosarcoma

History: 9 year old boy with nasal congestion and epistaxis (bloody nose) Osteosarcoma uncommonly arises in craniofacial bones, but when it does it occurs most often in bones of the jaw and has only very rarely been reported to arise in the nasal cavity or paranasal sinuses as a primary tumor. Most sinonasal osteosarcomas are high grade. … Continue reading


History: 35 year old male with lump underneath tongue. This is a pretty picture of a sialolith, which essentially is a calcified stone in a salivary gland duct. They most commonly form in the submandibular gland duct (Wharton’s duct) due to its long and upward going course.  Sialolithiasis presents with pain and swelling of the involved … Continue reading

Nails Driven Into Head by Nail Gun

History: Construction worker accident.  This happened in 2005 to a construction worker in Southern California. He had fallen off the roof of a home onto another worker operating the nail gun. At that point, the nail gun discharge six nails into his face, head and neck. Some of the nails penetrated his brain and came … Continue reading

Zygomaticomaxillary Complex Fracture – AKA Tripod Fracture

History: male hit in the face with a baseball bat. This is a great example of a zygomaticomaxillary complex fracture, also known as a tripod fracture. Some people refer to it also as a quadripod fracture. See a nice overview of the radiology facial fractures here. Additionally, learn about what the surgeon wants to know … Continue reading

Unknown case #31 – Skull radiograph

History: male with headache. What is your differential diagnosis? Comment and share below.

CT Neck Axial Anatomy

The following slides are from WikiRadiography (WetPaint) here.

Solution to Unknown Case # 13 – Fibrous Dsyplasia of the Skull Base

History: 10 year old girl with headaches and facial deformity. This is a case of fibrous dysplasia of the skull base. Fibrous dysplasia is a congenital bone disease resulting from abnormal osteoblast differentiation which results in the replacement of normal bone with a mixture of fibrous tissue and immature woven bone. It usually occurs in … Continue reading

Solution to Unknown Case # 11 – Differential Diagnosis of a Cystic Pediatric Neck Mass

History: 5 year old male with a midline neck mass.  This is the appearance of a lymphatic malformation, which use to be termed “cystic hygroma.” A lymphatic malformation is a congenital malformation of lymph channels which collect into embryonic lymphatic sacs. They can virtually be found in any head and neck location, and are characteristically … Continue reading

Cervical Ribs and Thoracic Outlet Syndrome

History: 10 year old female with neck pain. This is an example of cervical ribs, which are seen in less than 1% of the population. Cervical ribs are on the differential diagnosis for neck pain, and can be a cause of thoracic outlet syndrome. The thoracic outlet contains multiple spaces including the subcoracoid tunnel, costoclavicular … Continue reading

Unknown Case # 11 – Pediatric Neck Ultrasound

History: 5 year old male with a midline neck mass. What is your differential diagnosis for this pediatric patient with a midline neck mass? Comment and share below! Note, doppler color images revealed no vascular flow within the mass.