I have been to the radiologist center before. They never talk or show anything after the ultrasound imaging done. If I ask anything
after the imaging, they say that the reports will be sent to tht doctor and radiologist will report it. The sonographer say this to me . I am not sure if it’s the same for CT.
I am waiting to schedule it for my PCP or add in those details. I sent her an email and no response. Called their office too and they said Dr will get back to me. Still waiting.
Don’t want to schedule it before she add in those.
What is mean by pick a time when it’s slow mean?
And, we will get the cd burnt on the same day? How did you all get? Does it take a couple of days? I had MRI before and I got the cd before I leave their office.
That’s usual protocol, the technician does the scan and sends you on your way.There has been times, I can pull the radiologist in and discuss the scan after it is completed. They wont do it if you dont ask or push. I at least try. Ask when you check in and ask again when you get in and the scan is being done. If they are super busy, you are less likely to speak directly to the radiologist.
Sometimes you can get CT burnt right on the spot or it can take a couple days. Usually a radiologist will read scan and produce report by the end of day. This will vary from radiology centers, their protocols and how busy (or efficient) they are.
Thank you.
I never seen or spoke with a radiologist. The technician never let me meet the radiologist. I am going to the same place though and I have been nice to them. They are friendly too. But they won’t let the radiologist come to the scan room. I don’t know why.
Only thing is, I need my doctor to add in those for me. My tmj specialist and ENT did say that he couldn’t see anything related to eagles in CbcT, I still want to get it confirmed from a CT. Don’t know if it’s an overdo.
I asked my oral surgeon to see my pan xray and he said it’s not elongated.
Well I don’t think it is overkill to get the right scan to diagnose Eagles. I also have seen some well regarded university based ENT’s that I had a difference of opinion with as to how to proceed or even read and measure the styloids and deem them elongated. One didn’t even take the time to even look at the CT scan of neck. Luckily I was able to get Dr. Samji to read the scan before that consult. I already had an expert opinion when I walked in the door and a seasoned patient and challenged him the entire time. The guy was d#%%%k.
As I and others have indicated before, you need the right diagnostic tool to properly measure and determine elongated stylus and diagnose ES. That is the CT scan of neck. You also need an expert opinion (surgeon who specializes in ES) to ultimately read the scan and measure. Many radiologists and other docs measure differently and you are getting opinions based on other types of radiology that is not ideal to use for ES diagnosis. Its all over the map based of level of experience. Id let all the other noise of opinions fall back until you get the final opinion you need.
Pick a slow time means ask them what time of day is less busy than others for appointments then choose a less busy time to make yours. A lot of people tend to want the first appointments of the day or the last ones. Sometimes late morning or mid-afternoon are slower times.
Please remember that you could still have ES symptoms WITHOUT elongated styloids if your styloids are extra thick, curved, twisted or pointed. You can also have normal length styloids but have calcification of your stylohyoid ligaments which will also cause ES symptoms. So it’s not just elongated styloids that need to be noted but the quality of your styloids AND whether or not you have calcification on your stylohyoid ligaments. These things will all show up in your CT scan & can be assessed.
There are two very good & reputable ES surgeons in your state, Dr. Petruzzelli & Dr. Gupta. Have you tried contacting their offices? I have sent you their contact info before.
Thank you for the update, The Dude. I hope Dr. Samji is helpful for you. I’m sorry for what you’ve been through. That’s TERRIBLE! I hope you get better results from the surgeons in Bonn in Jan. Please let us know how your consult w/ Dr. Samji goes & what your surgery date is when you are scheduled.
@Isaiah_40_31,
I understand. To get all those styloids measurement and other things,I need that to be added in the doctor’s notes to the radiologist. My doctor is not responding to that yet. I have told her three to four times in the last three days to add that in the evaluation and no response from her.
I did call the radiologist office and they said they will look into the things which has been mentioned in the doctor notes nothing other than that. I’m waiting for my doctor’s response looks like she has been avoiding my email and not responding. Even I asked her about some LAB works and she missed some lab work in the annual physical last week and she’s not responding to it too. She said she did complete the thyroid profile and looks like the lab or she missed t3,t4. Got the results for only TSH. T3 and T4 missing. I have been sending her email about this and no response for this too. I am sure she is not very helpful to me in this case.
Dr. Petruzelli office is in Savannah. His office shows permanently closed in Google. I tried calling and no one picked up.
I don’t know about the other doctor Dr Gupta, can you please send his details.
Adding few images of reports which I got from my tmj cbct scan. I got this report online radiologist in another country. So my pcp is not trusting this report much as it’s from another country and she don’t know how to read cbct tmj scan. So she sending me to ct neck and said I don’t need mri of brain if I do CT.
I am attaching few images of those reports. Anyone see any calcification?
I’m sorry to hear about Dr. Petruzzelli’s office. Perhaps he’s retired. I will take him off our list. Dr. Gupta’s contact information is below. I just looked him up & saw he’s a neurologist so you may be right that there are no practicing ES doctors in your state. Dr. Samji is always a good option for a consult.
I’m sorry your PCP isn’t being helpful. She is probably overwhelmed w/ many patient requests because it’s so close to the end of the year. Hopefully she will come through & request your CT be evaluated for ES.
I noted before that your right styloid looks like it is in two pieces (but can’t tell for sure as the scan isn’t very clear) which could mean you have a normal length styloid & some calcification on your stylohyoid ligament (that would be the lower piece). If I am correct, that cold cause the symptoms you have w/ your tooth, jaw, neck, etc.
I agree Jules, a couple of those images appear to show elongation. I wonder if there is a way to measure them? Maybe hard without the right software.
New, I think it is too much to expect your PCP to know how to read these scans however I think there is enough there and they are labeled to justify an evaluation for eagles by radiologist in the new CT scan being ordered. Have you shown her the screens shots you have posted here?
I showed my PCP screen shots not even close to the quality of these and a peer reviewed article showing that CT Scan of neck without contrast as gold standard of diagnosis. He still thought it was TMJ but he did order CT with evaluation for eagles.
As to PCP not getting back to you…if you are using patient portal to send messages and not getting response, I have a suggestion. Call and talk to a nurse and request the radiology order be amended to include evaluation for Eagles. Id call daily until I got it added. I am finding recently that messages thru the portals are not answered in a timely way if even at all. It depends who is managing the messages and alot is falling through the cracks depending on the practice group. Sometimes I have had to call multiple times to get things accomplished.
Eagles Syndrome - a non-perceived differential diagnosis of temporomandibular disorder"
This is a very interesting research document on Eagles and also shows films that may be helpful to look at and compare areas. It also talks about the various radiology types than can be used to diagnose ES although this is from 2015. It is short but to the point and I thought easily understandable although I read these research documents all the time.
Thanks @Isaiah_40_31.
Why did you circle the left styloids ? Do you see anything on left too?
Yeah, I don’t know if it’s segmented with this scan view. I am trying today since morning to change this images to convert to 3D. Trying with radiant viewer. Hope I get it right. Will post the 3d images. I have been told that radiant viewer will measure the styloids length too. Is it?
No response from my PCP yet. I think she is dismissing me. I will wait for 2 more days and if she didn’t reply , i don’t know what to do. I thought of taking the scan before the year end as I met my deductible for this year.
I need to take mri for brain too. I am planning to try to take that too within this year. Don’t know if it’s possible.
My family says, don’t rush up with imaging because of deductibles met. Wait and do next year too. I don’t know what to do now.
Thanks @Jules.
Its measured as 26.54,27.05mm. Moreover not sure about this length as I got this from a radiologist from another country. I couldn’t get any radiologist here without an doctor order for reporting.
I am trying to convert my cbct to 3d. Will post it if I get it right.
Thank you @Snapple2020.
I didn’t show the screenshots to my PCP. I am sure she wont look into it and she doesn’t about eagles too.
I just showed her the report of tmjd cbct during the visit. Told the tmj specialist office to fax her the notes and reports if they have any. They sent her the notes. I emailed her the link for cbct images in the cloud drive. I don’t know if she take a look at it. I am sure she won’t be able to read it though as she told me earlier that she don’t know to read CT images.
I tried to call her office to talk to the nurse. They didn’t pick up. I left so many messages. I sent her a message in the portal too. Usually, she will respond the same day or within a week. Not more than that. This time, no response from her since dec9th. I am waiting to schedule CT without her notes about evaluation of eagles.
I am sure radiologist will not see about eagles if it’s not mentioned in doctor notes.
I met my deductible for this year. I am planning to get the imaging done before this year end. I don’t know if I should mri brain or ct neck before 31st. Considering I met the deductible, I am planning to do atleast one scan before this year ends. Or both if possible.
My family says, don’t rush for imaging. Wait and see how it goes. They don’t want me to do imaging only because I met the deductible. I don’t know what to do.
I have got an appointment for a neuro dentist oral surgeon for this 30th. It’s a long wait. He see tmj patients and nerve issue patients. My dentist sent me to him to see if my pain is from nerve injury or tmjd.
I don’t know if his visit will be different from the neurologist though. Neurologist visit doesn’t help me much. He sent me with mri brain order. Mri Neck not included.
I don’t know if I should ask neurologist to include mri neck and get it checked since I have small lump in the neck and under ear in the jaw.
I circled the left styloid to show it is in 1 piece & the right to show it looks like 2 pieces. That’s all. The styloid measurements are on the views where I circled the styloids.
For others who want a closer look, if you click on the images, you can download them to your computer then zoom in & see the styloid measurements & a closer view of the styloids. The middle & bottom images on the right have the styloid measurements.
I don’t know if the two long white things in the top right pic are styloids or something else. They look to be in the right place for the styloids, but the styloid images in the lower 2 right hand pictures look so different from the top picture, I wasn’t sure.
Yeah. I understand.
I will try to put it in radiant viewer. Hope it gives much clearer image and view.
I am waiting to get the ct done. Have only few days left in this year. Don’t know if it’s possible to get both the imaging done considering that I met the deductible. I don’t know if I am rushing.
Sorry, I missed the measurements on the screen shots.
That converts to 2.65cm and 2.70cm. Anything over 2.5cm is considered elongated per Eagles Syndrome diagnosis criteria and outside of normal limits. The report indicates that both styloid processes “are within normal limits” which is not accurate. It appears to me that you do meet the criteria. Isaiah is the resident expert on reading these films, but those long white things appear to be styloids to me.
I’m wondering if these some (not all) of these screen shots are sent to an ES specialist, whether it could suffice to get a diagnosis of Eagles?
Yeah @Snapple2020. I am not sure if that white thing is the styloids. I don’t think so. The tmj specialist would have told me if it’s styloids. He told me that he couldn’t see anything related to eagles and I can take that off my mind. I am not sure how experienced is he in diagnosing ES.
I couldn’t trust this report much. This is from a Radiologist from another country whom I got to know online . I paid him though. So I couldn’t trust 100% if his reports are 100%correct.
I will call some eagles specialist office and see if they take cbct scan. I didn’t try that yet. I am going to try to convert cbct in radiant viewer in sometime. Will see if it works.
My PCP just emailed me. She added the eagles evaluation in the scan order notes. I am just worried about the radiation exposure and thinking about it for scheduling.
I have taken many dental x-rays and 3 cbct scans. I don’t know if it’s ok to have many CT in short period of time. I am googling about it.
I don’t know which one to do. Mri or ct. It’s so confusing. I don’t want to do both at the same time even though I met deductible for this year. I am planning to do one. But it will be expensive if I do the other next year. But no other choice. Don’t know if it’s possible to do both before this year end.
