1887

Radiographic interpretation of the skull

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Abstract

Radiographs of the skull can provide important diagnostic and prognostic information; however, positioning and exposure have a huge impact on interpretation. General anaesthesia is usually required to prevent movement artefacts. This chapter examines indications for skull radiography and radiographic anatomy and interpretation.

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Figures

Image of 4.1
4.1 Detail of the mandibular incisor. The solid white arrow marks the more radiodense line of the lamina dura, the wall of the dental alveolus. The line of the occlusal surface of the mandibular incisors is a continuation of the line of the diastema. Note the normal position of the apex in relation to the 1st mandibular cheek tooth and the normal distance between the apical end of the tooth and the lamina dura in this radiograph (open arrow). The black arrow indicates the normal coronal extent of the pulp cavity, extending for approximately two-thirds the length of the tooth. (© Aidan Raftery)
Image of 4.2
4.2 Lateral views of the skull and mandible showing important anatomical landmarks. Solid arrows mark the temporal processes of the zygomatic bones (right and left). The dotted line marks the rostral border of the mandibular ramus, the coronoid process. The asterisk marks the orbital foramen. Note: this radiograph is not a true lateral view, which is why there are two lines around the tympanic bullae and two zygomatic processes of the temporal bone. (Radiograph © Aidan Raftery; skull model image courtesy of Frances Harcourt-Brown)
Image of 4.3
4.3 Rostrocaudal views of the skull showing the occlusal plane of the cheek teeth (arrows). The maxillary and mandibular cheek teeth are outlined in red. The maxillary and mandibular incisors are outlined in blue. The temporomandibular joints are also seen on this view (yellow line). (Radiograph © Aidan Raftery; skull model image courtesy of Frances Harcourt-Brown)
Image of 4.4
4.4 Lateral oblique views of the skull. This radiographic view allows the mandibular cheek teeth apices on one side and the maxillary cheek teeth apices on the contralateral side to be projected free from superimposition by the opposite sides. (Radiograph courtesy of Matthew Baraclough) (© Aidan Raftery)
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4.5 Converging diastema as a measure of normal clinical crown height. Elongation of the mandibular incisors is shown by the closed arrow. Elongation of the mandibular incisor apices occurs behind the 1st mandibular cheek teeth. There is an abnormal angle to the occlusal surface of the mandibular incisors (dotted arrow). Although still converging, the lines of the diastema (dashed lines) are moving closer to parallel, indicating elongation of the clinical crowns of the cheek teeth. (© Aidan Raftery)
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4.6 A fracture of the mandible can be seen just caudal to the 5th cheek tooth (dotted arrow) in this radiograph of a 3-year-old neutered female Dwarf Lop that had been attacked by a dog. The ramus of the mandible is displaced ventrally (solid arrowheads), which has resulted in incisor malocclusion. The upper and lower sides of the diastema (dotted lines) should be convergent or parallel and not diverging as here. The 2nd maxillary incisors are missing. This is common in dwarf rabbits. Each cheek tooth should be identified and evaluated separately. The 3rd maxillary cheek tooth is often the longest. There is elongation of the clinical crowns of all teeth, together with malocclusion of the incisors. The pulp cavity is more proximal in the incisors than normal, indicating a more rapid growth rate. (Courtesy of Frances Harcourt-Brown)
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4.7 The maxillary sinus is visible because it is filled with inflammatory exudate (open arrowheads). This rabbit has more advanced dental disease, with mineralization of areas of chronic inflammation (dotted arrow). There is remodelling of the ventral cortex of the mandible as the apices of the cheek teeth elongate. Malocclusion of the incisors is present, and the pulp cavity is reduced in size, indicating slow or arrested growth. The maxillary sinus is also visible in Figure 4.6 . (© Aidan Raftery)
Image of 4.8
4.8 Detail of the DV view of chronically diseased tympanic bullae with extensive remodelling of the lateral and rostral walls of the tympanic bulla, most severe on the right side (open arrowheads). The spheno-occipital fissure is marked by a closed arrowhead. (© Aidan Raftery)
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4.9 This rabbit had mineralization of chronic inflammatory tissue associated with an apical abscess extending from the right 1st and 2nd maxillary cheek teeth. The zygomatic process of the temporal bone is marked with a solid arrowhead. The temporal process of the zygomatic bone is marked with a dotted arrow. The 2nd maxillary cheek tooth has an elongated apex and is marked with a solid arrow. The bulla is normal. Skull model image of the same view. (Radiograph © Aidan Raftery; skull model image courtesy of Frances Harcourt-Brown)
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4.10 Nasolacrimal duct contrast study. The dotted arrow marks the end of the first narrow section. After this the duct is approximately 2 mm in diameter until the area of the apex of the primary maxillary incisor. At this point, which is marked by a solid arrowhead, the duct narrows to approximately 1 mm in diameter, makes a 90-degree bend medially and traverses to exit several millimetres caudal to the mucocutaneous junction at the alar fold. Note the normal occlusal plane of the cheek teeth. (© Aidan Raftery)
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4.11 DV view showing the temporomandibular joint (solid arrowhead). This rabbit also has a fibrosarcoma filling the distal part of the right external ear canal (margins marked with open arrowheads). (© Aidan Raftery)
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4.12 Hydrocephalus in a young rabbit. Doming of the bones of the neurocranium is evident in this 7-week-old rabbit. The owner reported that it had been born with an abnormally shaped head. The normal diamond-shaped hyoid bone is identified by the white arrow. (Courtesy of Sergio Silvetti)

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