Case of the Week
Phys Di-
Syllabus Test Dates Section 12:05 Grades Section 12:05 Notices Section 1:55 Grades Section 1:55 Notices
- Clinical Psych
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Syllabus Test Dates Grades Notices
- Rad I Lab review
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Lab III Misc. Rad I Images
- Clinic Abroad
- ICN Seminar
- Special Topics
Answer:
FINDINGS:
IMPRESSIONS:
DISCUSSION:
The diagnosis of Eagle syndrome is made by correlation of the clinical symptomatic presentation, physical examination, and radiographic examination. Radiographs will reveal an elongated and calcified stylohyoid ligament, typically extending from the angle of the mandible towards the hyoid bone.
Approximately 4% of the population has an elongated and calcified stylohyoid ligament, but rarely is this finding symptomatic, usually representing a clinically insignificant variant.
Complications of this syndrome include compression of the adjacent structures that are innervated by the glossopharyngeal and trigeminal nerves. Compression of the adjacent carotid arteries. Surgical removal may be required, but is uncommonly performed unless clinically significant.
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The C6 and C7 vertebrae are not fully seen on the lateral view. Calcification of the bilateral stylohyoid ligaments is noted, seen on the lateral radiograph extending from the mastoid region to the hyoid bone and on the APOM radiograph over the C1 transverse processes. The prevertebral soft tissues are clear. Diminished disc spaces and mild osteophyte formation are noted at the C2 disc level. Nuclear impressions (notochordal persistency) is present at the C2-C5 levels. Osseous density appearsadequate. The cervical spine is hypolordotic and exhibits mild anterior weight-bearing.
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Calcification of the stylohyoid ligament. With clinical confirmation of symptoms, the diagnosis may be Eagle's Syndrome.
Mild degenerative disc disease at C2.
Cervical hypolordosis with anterior weight-bearing.
Nuclear impressions (incidental finding).
Eagle described his eponymous syndrome in a group of patients who had symptoms of a foreign-body sensation in the throat, dysphagia, intermittent pain in the pharynx that radiated to the mastoid, possible pain along the carotid artery pathway, and possible taste dysfunction. Eagle theorized that his patients, having had previous tonsillectomies, also had scar tissue in the tonsillar fossa that incorporated branches of the glossopharyngeal nerve.