# New here. How to diagnose if I have eagle syndrome. Whom to see? ENT or TMJ specialist or neurologist? **URL:** \ **Category:** General\ **Created:** [September 15, 2020, 8:32pm UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944 "2020-09-15T20:32:18Z")\ **Posts on this page:** 20\ **Page:** 14
**Author:** ![Newuserhere](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Newuserhere](https://forum.livingwitheagle.org/u/Newuserhere)\ **Post date:** [December 24, 2020, 11:17pm UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/263 "2020-12-24T23:17:08Z")
@Snapple2020, @Isaiah_40_31, @Jules, @TheDude I got an email from the Radiologist center and they said they will update the report. He updated it and it has only the left side measurement first. I had to email them back to back 3 times to update for both the side measurements. I got this as a final. I don’t know if it’s missing something. Please let me know. 4.30pm Addendum: The left stylohyoid ligament is calcified and measures 2.4 cm, which is borderline top normal. This is in continuation of the left styloid process, which essentially can be considered elongated. 12/24/2020 3:47 PM Addendum: The right styloid process is not elongated. The calcified distal portion of the right stylohyoid ligament measures 0.8 cm and is located about 2.1 cm from the tip of the right styloid process. 12/24/2020 1:59 PM Addendum: Additional clinical indication: Evaluation for Eagle’s syndrome. The left stylohyoid ligament is calcified and measures 2.4 cm, which is borderline top normal. The right stylohyoid ligament is mildly calcified along the distal aspect on series 4, images 34-35. –ends I couldn’t understand anything much. This has sent to my PCP as well. I am 💯 sure she won’t be able to understand or interpret these results. I don’t know how to go from here. The report says calcification on left where I don’t have any symptoms. What does my report say ? Eagles? Did anyone understand it completely? ---
**Author:** ![Isaiah\_40\_31](https://yyz1.discourse-cdn.com/flex027/user_avatar/forum.livingwitheagle.org/isaiah_40_31/32/3054_2.png) [@Isaiah\_40\_31](https://forum.livingwitheagle.org/u/Isaiah_40_31)\ **Post date:** [December 25, 2020, 5:30am UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/264 "2020-12-25T05:30:12Z")
Congratulations! Your persistence paid off! I disagree w/ the radiologists diagnosis of your right side. Because part of your stylohyoid ligament has a .8 cm section that is calcified, that would be classified as Eagle Syndrome. The radiologist who evaluated your scan obviously thinks that only styloid elongation is ES. We have had members who had normal styloids but their ligaments had calcification on them. They had the same types of symptoms as the people who have elongated styloids. Once the calcified ligaments were removed, those people recovered from their symptoms just as many do who have elongated styloids removed. In the **4:30 PM** section in the last sentence it says “which essentially can be considered elongated.” The radiologist is saying your left styloid is elongated but not very much beyond normal. My note: That is still long enough to cause ES symptoms. In the **3:47 PM** section " the calcified distal portion of the right stylohyoid ligament measures .8 cm & is located about 2.1 cm from the tip of the right styloid process" My note: This means that there is a space of 2.1 cm between the tip of the right styloid & the section of the stylohyoid ligament that is calcified. That’s why it looks like there are 2 pieces of styloid on your right side. One piece is your styloid, then there is a gap of 2.1 cm then a .8 cm section of your stylohyoid ligament is calcified. That bit of calcification could be what is causing your tooth & face pain symptoms on the right side. I recommend you get 2 copies of your CT scan on disc & mail one to Dr. Samji even though he said he won’t look at CTs w/ contrast. You can send a note saying your doctor was unwilling to refer you for a CT w/o contrast even though you requested it. Hopefully he’ll still evaluate your CT & at least give you his opinion. There are a couple of doctors closer to you who are good ES surgeons. One is Dr. Milligan in Phoenix, Arizona [http://www.aocphysicians.com/](http://www.aocphysicians.com/), & the other is Dr. Nuss in Baton Rouge, Louisiana, [https://ololrmc.com/site-search/search-results?q=dr](https://ololrmc.com/site-search/search-results?q=dr) The reason I suggested you email the Eagle’s info to the gal who did your CT scan is so she can learn about it not so she can forward it. It would be good for her to know what ES is since she clearly had no idea when you talked to her about it yesterday. Radiology clinics are required to keep scans on record for 10 years after a scan is done. You will have access to yours for that amount of time. I hope this information helps. ---
**Author:** ![Jules](https://yyz1.discourse-cdn.com/flex027/user_avatar/forum.livingwitheagle.org/jules/32/404_2.png) [@Jules](https://forum.livingwitheagle.org/u/Jules)\ **Post date:** [December 25, 2020, 6:32am UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/265 "2020-12-25T06:32:07Z")
That’s ‘good’ in that it does confirm ES- I agree with what Isaiah has said & she’s said it better than I could! So well done for persevering, & I think that this gives you the answer- that it’s worth pursuing rather than having teeth pulled! ---
**Author:** ![Newuserhere](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Newuserhere](https://forum.livingwitheagle.org/u/Newuserhere)\ **Post date:** [December 25, 2020, 3:16pm UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/266 "2020-12-25T15:16:16Z")
Thank you @Isaiah_40_31. How do I interpret this result for the measurements of styloids process? How much is my right and left styloids? ---
**Author:** ![Newuserhere](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Newuserhere](https://forum.livingwitheagle.org/u/Newuserhere)\ **Post date:** [December 26, 2020, 12:36am UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/267 "2020-12-26T00:36:59Z")
@Isaiah_40_31, Does my results indicate the definite diagnosis for eagles? I don’t understand much from the report. I am sure my PCP won’t understand too. I don’t know if I need to see an eagles provider for diagnosis? Can we see the measurements by ourselves with any software? I am going to try with radiant viewer. ---
**Author:** ![Isaiah\_40\_31](https://yyz1.discourse-cdn.com/flex027/user_avatar/forum.livingwitheagle.org/isaiah_40_31/32/3054_2.png) [@Isaiah\_40\_31](https://forum.livingwitheagle.org/u/Isaiah_40_31)\ **Post date:** [December 26, 2020, 12:41am UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/268 "2020-12-26T00:41:17Z")
The radiologist didn’t give a measurement for your right styloid, only the length of the calcification on your stylohyoid ligament which is just short of an inch below the tip of your styloid process (see the images you sent where I made two circles.) The bottom circle of the two is your calcified ligament & is likely what’s causing the trouble. The comment about your left styloid is unclear. Since a normal styloid is 2.54 cm, his measurement of 2.4 would not be borderline long but within normal range. I wonder if he means the stylohyoid ligament is calcified 2.4 cm beyond the type of the styloid thus making the total length 4.94 cm. That would definitely classify as elongated. You will have to get the opinion of a professional for sure to decipher what the radiologist means. The Dude gave you good information about how to translate your CT slices into a 3D image. There is a 3D slicer program on our forum. Click on this link for instructions: > [@Making Your Own 3D Images from CT Scan- 3D Slicer Tutorial](https://forum.livingwitheagle.org/t/making-your-own-3d-images-from-ct-scan-3d-slicer-tutorial/988): > > The Amazing 3D Slicer Tutorial! This is a step by step walk-thru for anyone who wants to render or play with their CT scans. I'm going to focus specifically on rendering a model to view the styloids. I'm using Windows for this guide. Also, the images are embedded so be sure to use the DESKTOP VIEW if you're on a mobile device. This tutorial is broken down into Little steps so even those who aren't very comfortable with technology can use the program. It looks long, but it's easy! There'… ---
**Author:** ![Newuserhere](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Newuserhere](https://forum.livingwitheagle.org/u/Newuserhere)\ **Post date:** [December 26, 2020, 3:53am UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/269 "2020-12-26T03:53:37Z")
Thank you @Isaiah_40_31. Yeah. I understand that radiologist didn’t give the report properly. I was keep mailing them back to back to get these updated report. I don’t know if I should contact him again on Monday for proper measurements. This has to go from my doctor. But she won’t be knowing or able to understand this report. I don’t know if the radiologist will do it again and update the report if a patient asks. It’s kind of not clear about the measurements. Most of the providers rely on Radiologist reports only. So this is not convincing for me. I feel bad that he rushed so much for the report and didn’t check for eagles properly. I have to keep mail them back for left side measurement. I think it’s better to ask him on Monday for proper measurements. But they might respond like A medical provider can interpret these results. It would have been better if my PCP knows about it: ( I am also planning to call deal Samji office on Monday to ask if they take ct with contrast. I communicated with the assistant through email earlier and she told to check the email properly and only ct without contrast accepted . I don’t want to send the CD without talking to them first if they take it. I have to find another provider if they say, they won’t accept. ---
**Author:** ![Isaiah\_40\_31](https://yyz1.discourse-cdn.com/flex027/user_avatar/forum.livingwitheagle.org/isaiah_40_31/32/3054_2.png) [@Isaiah\_40\_31](https://forum.livingwitheagle.org/u/Isaiah_40_31)\ **Post date:** [December 26, 2020, 7:06pm UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/270 "2020-12-26T19:06:09Z")
You don’t need a new radiology report. Any doctor familiar w/ ES will understand what the report says & it does say you have ES. Also, any good ES doctor will measure the styloids & ligament calcification themselves rather than trusting what the radiologist says. The numbers are somewhat arbitrary as each person who measures them is likely to come up w/ a different number. For now just rest & know that you have a diagnosis. When you talk to Dr. Samji’s ofc on Mon. make sure you mention that you didn’t have a choice abt your CT & that you specifically requested no contrast but it was given anyway. Ask if he will at least look at it w/ that in mind. ---
**Author:** ![Snapple2020](https://avatars.discourse-cdn.com/v4/letter/s/c89c15/32.png) [@Snapple2020](https://forum.livingwitheagle.org/u/Snapple2020)\ **Post date:** [December 27, 2020, 5:21pm UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/271 "2020-12-27T17:21:10Z")
I already commented on the other thread on this. I agree with Isaiah, you do not need a new radiology report and will not get any more out of the radiologist. This is why surgeons want to read the scans themselves. The new report indicates segmented (.8cm) on one side + 2.1cm measurement out to the end, the other side 2.4 which does indicate eagles. Your previous report shows 2.65cm and 2.70cm. Based on the two reports, you are in Eagles syndrome realm and need a specialist to confirm it. I would not call Samji’s office as the gatekeeper is not letting you in and may just deny you again. I would mail the CT scan along with the screen shots of previous scans with a letter of explanation and hope for the best, he will at least review. You can request he put in writing you need a CT w/o contrast. You can then take that to your PCP. ---
**Author:** ![Newuserhere](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Newuserhere](https://forum.livingwitheagle.org/u/Newuserhere)\ **Post date:** [December 27, 2020, 10:50pm UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/272 "2020-12-27T22:50:31Z")
Thank you @Isaiah_40_31. Yeah. The reports are confusing. The measurements are not so clear. The cbct report shows a different measurements and this CT scan doesn’t have a proper measurements of styloids process. I would ask the radiologist again. Beacuse if Samji office doesn’t accept me scan when I ask them tomorrow. I have to find another provider and if he see the report and not the scan by himself for the findings. In that case, I will be lost if the provider rely on this report. I don’t know if Samji office accepts scan with contrast. Let me request them again. The assistant told me in the email that they won’t take anything else. ---
**Author:** ![Newuserhere](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Newuserhere](https://forum.livingwitheagle.org/u/Newuserhere)\ **Post date:** [December 27, 2020, 10:57pm UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/273 "2020-12-27T22:57:47Z")
Thank you @Snapple2020. I will check with his office tomorrow once if they accept ct with contrast. If they reject it, I have to find another provider nearby. I am in Atlanta. ---
**Author:** ![Newuserhere](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Newuserhere](https://forum.livingwitheagle.org/u/Newuserhere)\ **Post date:** [December 27, 2020, 11:13pm UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/274 "2020-12-27T23:13:19Z")
@Isaiah_40_31, @Jules, @Snapple2020, @TheDude I have some lump spots in the neck which is pea like size and hard. It’s still the same since july and it’s hard to touch. I had ultrasound and nothing found. I have a small lump like spot in the lower jaw under ear and side of the neck. The lump spot under ear is very sore and tender to touch. During the CT, the technician asked to show me the lump spots. I showed 3 spots. I have one more lump spot in the chin. Technician placed some stickers on those spots. But the report doesn’t say anything about those lump spots or the marked stickers. Do I need to ask the radiologist about it? I really want to know what those lumps are. I don’t know if the radiologist missed that too. Normally they will place stickers for lump spots?? ---
**Author:** ![TheDude](https://yyz1.discourse-cdn.com/flex027/user_avatar/forum.livingwitheagle.org/thedude/32/3071_2.png) [@TheDude](https://forum.livingwitheagle.org/u/TheDude)\ **Post date:** [December 28, 2020, 12:29am UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/275 "2020-12-28T00:29:19Z")
I am having these lump spots too. I would say that these are so called myogelosis, a hardening of muscles. It is typical that these are not seen in x-rays or ultrasound. Osteopaths are familiar with that. I can solve them by massaging, pushing or pinching and pulling these spots with my fingers. ---
**Author:** ![Newuserhere](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Newuserhere](https://forum.livingwitheagle.org/u/Newuserhere)\ **Post date:** [December 28, 2020, 12:32am UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/276 "2020-12-28T00:32:08Z")
Oh ok. Thanks. I have these spots for more than 8 months now. It’s still the same and not increased in size too. ---
**Author:** ![Isaiah\_40\_31](https://yyz1.discourse-cdn.com/flex027/user_avatar/forum.livingwitheagle.org/isaiah_40_31/32/3054_2.png) [@Isaiah\_40\_31](https://forum.livingwitheagle.org/u/Isaiah_40_31)\ **Post date:** [December 28, 2020, 12:49am UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/277 "2020-12-28T00:49:21Z")
Another option is that they’re small lymph nodes that are reacting to everything going on in that area right now. That would most likely mean they are insignificant. I would think if they were a problem, the radiologist would have commented on them as the markers place on them will show up in the CT scan. It’s a good idea to ask for the radiologist to comment on the areas where the markers are. It really sounds like he wasn’t paying attention to the instructions he was given. Also, I believe most doctors will read the scans themselves because radiology opinions do vary i.e. if you were to give your scans to another radiologist to read, you would probably get a different styloid measurement & perhaps some other comments would differ as well. I did send you the names of a couple of other doctors nearer to you than Dr. Samji. You could try contacting them as well. ---
**Author:** ![vdm](https://yyz1.discourse-cdn.com/flex027/user_avatar/forum.livingwitheagle.org/vdm/32/4794_2.png) [@vdm](https://forum.livingwitheagle.org/u/vdm)\ **Post date:** [December 28, 2020, 5:50am UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/278 "2020-12-28T05:50:41Z")
It’s just to important not to mix them up with any salivary glands, especially in the jaw/chin area (submandibular gland etc.). You’d probably not want to pinch them. > **[Salivary gland](https://en.wikipedia.org/wiki/Salivary_gland#/media/File:Blausen_0780_SalivaryGlands.png)** > > The salivary glands in mammals are exocrine glands that produce saliva through a system of ducts. Humans have three paired major salivary glands (parotid, submandibular, and sublingual), a pair of seromucous tubarial glands (discovered in 2020) as well as hundreds of minor salivary glands. Salivary glands can be classified as serous, mucous or seromucous (mixed). > In serous secretions, the main type of protein secreted is alpha-amylase, an enzyme that breaks down starch into maltose and glucose, ... ---
**Author:** ![Newuserhere](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Newuserhere](https://forum.livingwitheagle.org/u/Newuserhere)\ **Post date:** [December 28, 2020, 5:41pm UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/279 "2020-12-28T17:41:14Z")
I just got an email from Samji assistant. She told me to send the scan. But if doctor wants a new scan, they said I have to get a new one. Cbct scan is not allowed. She told me not any dental scans allowed. She told me that I have to make sure styloids measurement should be there in the scan. I told them I don’t know how to read the scans and am sure measurements should be there in the scan. I have to send them the cd and report. I thought of sending cbct scan as well as it shows some styloids measurement clearly. Let me see. ---
**Author:** ![Jules](https://yyz1.discourse-cdn.com/flex027/user_avatar/forum.livingwitheagle.org/jules/32/404_2.png) [@Jules](https://forum.livingwitheagle.org/u/Jules)\ **Post date:** [December 28, 2020, 8:22pm UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/280 "2020-12-28T20:22:49Z")
I’m UK, so can’t say too much about how Dr Damji works, but I can’t see as it would hurt to send what you have… ---
**Author:** ![Newuserhere](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Newuserhere](https://forum.livingwitheagle.org/u/Newuserhere)\ **Post date:** [December 28, 2020, 8:45pm UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/281 "2020-12-28T20:45:56Z")
Wouldn’t you mean?? @Jules. Yeah. I am going to send what I have ---
**Author:** ![Newuserhere](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Newuserhere](https://forum.livingwitheagle.org/u/Newuserhere)\ **Post date:** [December 28, 2020, 9:06pm UTC](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944/282 "2020-12-28T21:06:10Z")
> [@Isaiah\_40\_31](#): > > It’s a good idea to ask for the radiologist to comment on the areas where the markers are. It really sounds like he wasn’t paying attention to the instructions he was given. @TheDude, @Snapple2020, @Isaiah_40_31, @Jules. I asked the radiologist today, I told them that my specialist assistant is asking for more details. The radiologist center emailed me today that he added few more details and told me this. “Addendum completed. Please advise her to get a copy of her images and allow her specialist to review it in conjunction with the clinical examination.”" The report says the below: MD on 12/28/2020 3:43 PM Addendum: Right styloid process: Not elongated, measuring about 0.3 cm. Right stylohyoid ligament: Calcified distal portion, which measures about 0.8 cm. This is located about 2.1 cm from the tip of the right styloid process. Left styloid process/stylohyoid ligament: Borderline top normal size of the left stylohyoid ligament, which is in continuation with the elongated left styloid process, measuring about 2.4 cm combined. One cannot differentiate between what is considered the left styloid process and a calcified stylohyoid ligament in this case. In regards to Eagles Syndrome, an elongated styloid process or a calcified stylohyoid ligament can both result in pain. Eagles Syndrome is ultimately a clinical diagnosis. Two BB markers were place in the region of focal pain in the right face and right neck. There is no focal abnormality underlying these BB markers. Just updating here if any of you can understand. I am going to send this report to Samji as well. Hope he can see my scan. It might or might not happen. The assistant said he might ask for a new scan too. [Previous page](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944.md?page=13) [Next page](https://forum.livingwitheagle.org/t/new-here-how-to-diagnose-if-i-have-eagle-syndrome-whom-to-see-ent-or-tmj-specialist-or-neurologist/7944.md?page=15)