ABSTRACT
BACKGROUND AND PURPOSE: Osteoma cutis of the face represents a primary or secondary formation of ossific foci in the facial skin. Its primary form has been sparsely described in the plastic surgery and dermatology literature. As radiologists, we routinely encounter incidental, very small facial calcified nodules on CT studies performed for a variety of unrelated reasons. We hypothesized that this routinely encountered facial calcification represents primary miliary osteoma cutis and is a common, benign, age-related finding. MATERIALS AND METHODS: We retrospectively reviewed 1315 consecutive sinus CTs obtained during an 8-month period and their associated demographics. The number of dermal radiopaque lesions with Hounsfield units of >150 was counted, and we analyzed the association between the prevalence of these lesions and patients' demographics with logistic regression methods. RESULTS: Five hundred ninety-nine males and 716 females from 4 to 90 years of age were included in the study (mean, 52 versus 51 years; P = .259). Among these, 252 males and 301 females had small facial calcified nodules (42.1% versus 42.0%, P = .971). The patient's age was a statistically significant predictor for having facial calcified nodules (odds ratio = 1.02, P < .001), while the patient's sex was not (P = .826). CONCLUSIONS: Facial calcified nodules, observed in routine head and face CT imaging, are common, benign, age-related findings, which have been largely overlooked in the radiology literature. It is a manifestation of primary miliary osteoma cutis.
Subject(s)
Bone Diseases, Metabolic/diagnostic imaging , Facial Neoplasms/diagnostic imaging , Ossification, Heterotopic/diagnostic imaging , Skin Diseases, Genetic/diagnostic imaging , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Bone Diseases, Metabolic/epidemiology , Calcinosis/diagnostic imaging , Child , Child, Preschool , Face/diagnostic imaging , Facial Neoplasms/epidemiology , Female , Humans , Incidental Findings , Male , Middle Aged , Ossification, Heterotopic/epidemiology , Prevalence , Retrospective Studies , Sex Factors , Skin Diseases, Genetic/epidemiology , Tomography, X-Ray Computed , Young AdultABSTRACT
OBJECTIVES: To compare (1) the accuracy of 3DCT with rapid prototyping (RP) models and (2) their application in the management of coronoid hyperplasia. METHODS: An adult dry skull was used to compare 3DCT and a RP model for accuracy of reproduction; Polymerisation contraction and 17 distances between 27 anatomical points were measured. Two patients with coronoid process hyperplasia were assessed by means of 3DCT and plastic models. RESULTS: Differences in measurements with the RP model and the dried skull were smaller than those with 3DCT (P=0.04). Polymerisation contraction was greater than the errors in reproduction with the RP model and approximately equal to those with the 3DCT. The coronoid process was thick and prominent in the patients with coronoid process hyperplasia and the small space and early contact between zygomatic arch and the coronoid process demonstrated. The plastic model duplicated the exostosis of the inner surface of the malar bone facing the concavity of the elongated process. The coronoid process had an anterior tilt in one case. CONCLUSION: The plastic model duplicated the relationship between the maxillofacial deformity and the coronoid process with tolerable accuracy. Trismus may be due to the direction as well as the length of the enlarged coronoid process.
Subject(s)
Imaging, Three-Dimensional/methods , Mandible/diagnostic imaging , Mandible/pathology , Models, Anatomic , Adolescent , Adult , Child , Humans , Hyperplasia , Male , Mandible/surgery , Observer Variation , Oral Surgical Procedures/methods , Patient Care Planning , Plastics , Polymers/chemistry , Range of Motion, Articular , Reproducibility of Results , Tomography, X-Ray Computed/methods , Zygoma/pathologyABSTRACT
Magnetic resonance imaging and computed tomography was performed in one and two patients, respectively, with renal osteodystrophy (ROD). Conventional radiographs clearly depicted the characteristics of ROD of the oral and maxillofacial region. CT and MRI did not add any more information.
Subject(s)
Chronic Kidney Disease-Mineral and Bone Disorder/diagnostic imaging , Jaw Diseases/diagnostic imaging , Adult , Gigantism/diagnostic imaging , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
OBJECTIVES: The purpose of this study was to examine the frequency, chemical composition, and radiographic and morphologic features of multiple miliary osteomas of the facial skin. STUDY DESIGN: Facial skin was obtained from 33 cadavers. After contact radiographs were taken, osteomas were examined by photo and scanning electron microscopy. Radiographic microanalysis of inorganic elements of the osteomas was also performed. In addition, clinical dental radiographic examinations were performed on 158 living subjects. RESULTS: Radiographic examination revealed milia-like osteomas in the facial skin of all of the cadavers. Nodules of 0.5 to 2.0 mm in diameter were scattered symmetrically in the skin of the cheek, mandibular angle, and forehead. Each nodule consisted of a concentric, multilamellated, osteoid cortex and an adipose medulla. Microanalysis suggested the presence of hydroxyapatite similar in composition to that of normal cortical bone. The condition was detected in 28% (44/158) of the living subjects by clinical dental radiographic examination. CONCLUSION: Multiple miliary osteoma is a very common condition and may not be related to specific diseases.
