Imaging Sci Dent.  2018 Mar;48(1):67-72. 10.5624/isd.2018.48.1.67.

Fractured styloid process masquerading as neck pain: Cone-beam computed tomography investigation and review of the literature

• Khan HM
• Fraser AD
• Daws S
• Thoppay J
• Mupparapu

• KMID: 2406985
• DOI: http://doi.org/10.5624/isd.2018.48.1.67

Abstract

Historically, Eagle syndrome is a term that has been used to describe radiating pain in the orofacial region, foreign body sensation, and/or dysphagia due to a unilateral or bilateral elongated styloid process impinging upon the tonsillar region. Because elongated styloid processes-with or without associated Eagle syndrome-can present with various symptoms and radiographic findings, it can be challenging for healthcare practitioners to formulate an accurate diagnosis. Abnormal styloid anatomy can lead to a multitude of symptoms, including chronic orofacial/neck pain, thus masquerading as more commonly diagnosed conditions. In this report, we describe a patient who presented to our department with styloid process elongation and fracture. A careful history, physical examination, and a conebeam computed tomography (CBCT) investigation led to the diagnosis. The patient was then referred for appropriate care. This case report demonstrates the utilization of CBCT in differentiating a fracture site from a pseudo-joint that might mimic a fracture.

Keyword

Cone-Beam Computed Tomography; Neck Pain

MeSH Terms

Cone-Beam Computed Tomography*
Deglutition Disorders
Delivery of Health Care
Diagnosis
Eagles
Foreign Bodies
Humans
Neck Pain*
Neck*
Physical Examination
Sensation

Figure

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  Fig. 1 A panoramic reconstruction cone-beam computed tomography image of the patient shows the elongated styloid processes bilaterally and the fractured left styloid process (arrow).

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  Fig. 2 A sagittal cone-beam computed tomography image of the skull shows only the left styloid process (arrows).

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  Fig. 3 A coronal cone-beam computed tomography image shows the styloid processes bilaterally and identifies the fractured left styloid process (arrows).

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  Fig. 4 An axial cone-beam computed tomography image shows the styloid processes bilaterally and identifies the fractured left styloid process (arrows).

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  Fig. 5 Multiplanar reconstruction cone-beam computed tomography images show the fractured styloid process (arrows) in all 3 views.

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  Fig. 6 Three-dimensional reconstruction cone-beam computed tomography image shows the fractured left styloid process (arrow).

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