Presentation
Facial discomfort.
Patient Data
The right maxilla and mandible are expanded, with groundglass opacity seen in the right maxilla.
Findings are most in keeping with fibrous dysplasia.
Mesially impacted left mandibular third molar.
Very prominent changes consistent with known fibrous dysplasia are demonstrated throughout the facial skeleton most pronounced on the left in the frontal bone, bilaterally involving the base of skull, and right maxilla. The mandible is also involved, more so on the right. The upper cervical spine appears unremarkable.
Gas is seen tracking from the nasal cavity on the right into the premaxillary soft tissues and extend laterally as far as the root of the zygoma. This is associated with significant soft tissue stranding and multiple fluid collections; these changes are the result of recent surgery, and when compared to the previous CT from months ago there has been significant resection of the anterior maxillary excess bone. The orbit is unremarkable.
Conclusion: Changes consistent with fibrous dysplasia
Case Discussion
The appearances are those of fibrous dysplasia, a genetic disease. With the radiological appearance, in this case, it is hard to consider other differentials.
The presence of ground-glass matrix in the bone lesion on the OPG and also on the CT images is a good indicative of the condition.