I met with an ENT on Monday who wanted to perform a CT to check my sinuses. So, since we were up there already, I asked them to include the neck and ensure I could use the images for other diagnoses my primary care is exploring (i.e., Eagles!) So I have a CT / CTA that the ENT immediately (within 15 minutes of images taken) said “You don’t have Eagle syndrome”. He also said my sinuses look great. However, I haven’t been able to get a report of the findings (or lack thereof) from the provider that performed the CT.
Luckily, they sent me a link to the images before I left my appointment, so I have been playing around on the viewer and learning a lot about normal and abnormal structures.
So I have two questions – first, does anyone see what I see? (Problems up there.)
Second, if others agree there is something worth exploring on this imaging, and I am unable to get the provider to interpret the CT… what next? Does anybody have experience scheduling an appointment with a specialist to treat this when the imaging doesn’t have a written interpretation? Any recommendations or tips? I’d really like an expert to get a good look at my scan.
Unfortunately, the link to the images expired after 48 hours so I’m stuck with some screencaps and videos I took yesterday. I’m seeing my PCP tomorrow, who has also requested results of the imaging, so maybe an interpretation will be offered then. I went to the dentist yesterday also for botox injections to my masseters, as TMJ has been floated as a potential cause. But the muscles are extremely tight and the dentist wouldn’t do it and referred me to an oral surgeon instead. I am pretty uncomfortable and hope I am on the right track here.
Hi Pigeon. Firstly, your imaging is yours. That facility should be willing to give you all the files in some way, usually on a CD; most of the time its free or a small charge. Secondly, I believe all the Drs that treat eagles will interpret the imaging independently, they don’t need a report; granted, most imaging should come with a report that usually takes 1-2 days.
I also thought my symptoms were TMJ, my ES was actually caught during imaging for a night guard. The imaging showed healthy joints, so the TMJ was muscle based. Physical therapy, with dry needling being the main treatment, was quite effective. But, symptoms still persisted, which led to me to ES. They are quite different treatments for different problems, if your jaw joints are healthy then jaw surgery probably won’t be a benefit.
You do have some slightly elongated styloids; angle and thickness play a part too. Please reply with your symptoms because ES is diagnosed via imaging and symptoms. Please look at the Dr list and start researching Drs you would like to see; just search their name on the site and read testimonials; its how I found my doctor. There is also a FB group if you want to join that.
I’ve annotated a couple of your images but do agree w/ @Andy89316 that your L styloid looks a bit longer than it should plus it’s growing at a somewhat different angle than some we’ve seen i.e. toward your jawbone rather than parallel to it. In the second image it looks like it’s curving inward toward nerves, veins & arteries, too. It also appears the transverse process of C1 (which oddly looks like pinchers) may be constricting your IJV in that head position.
The images of your right styloid don’t show the entire styloid so I can’t tell you if it’s elongated or not. In the first image of the right side, there are vascular tissues obscuring it. In the second one, it’s barely present. I circled the bit I can see.
The picture pinching the jugular but not pressing against the styloid is interesting. Poster has to remember what might be happening with movement. This might be a case that fits something i posted here before about from an interventional radiologist who said removing the styloid didnt help in a lot of cases. You had to deal with c1 because styloid wasnt causing the problem.
I agree that the styloids look like they could potentially be causing an issue, the left longer than average & the right looks a weird shape ( very kinky!)
But as @JugularEagle says, the C1 processes look quite long & like they’re compressing the IJVs- obviously muscles can’t be seen in a CT but it could be that the C1 is pushing the IJVs against a muscle, as it doesn’t look like the styloids are part of the compression…
If you’re able to see someone who does a C1 shave, then that might be an idea, to Dr Nakaji in AZ for example…
Hard to tell with these images. Radiologist at imaging center interprets and writes the report. The provider will have their own interpretation they discuss with you at your visit but don’t write an interpretive report, only a visit note.
