Monika Sharma

Abstract

Ludwig angina is a potentially lethal acute cellulitis of the floor of the mouth and neck, including submandibular, submental and sublingual spaces and ultimately leading to airway obstruction. Computed tomography (CT) of the neck with upper thorax has been used in emergency once the airway obstruction is secured to evaluate the severity of the infection, to assess any abscess and mediastinal extension. Therefore knowledge of imaging features of Ludwig’s angina is essential to ensure an accurate diagnosis and initiation of early treatment. CT also plays an important role in evaluation for need of surgical intervention. However, MRI is superior to CT because of its excellent soft tissue contrast and demonstration of various fascial compartments' involvement. Keywords: Computed tomography, Dental, Infection, Ludwig's Angina, Magnetic Resonance imaging

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Abstract

We report a rare case of congenital cervical anomaly in a 32 yr old female, who was referred in our department for the complaints of chronic cervical and shoulder pain with a hard cervical mass. Antero-posterior and lateral radiographs of the cervical spine were performed, which show a rib like bony projection, in the left side of neck and on the lateral radiograph, it was corresponding to a hypertrophied C6 spinous process. CT study was done for better delineation of this congenital anomaly, which showed hypertrophied left lamina of C6 and spinous process, crossing midline and towards the left side, extending inferiorly up to the level of thoracic inlet. There was associated fusion of C3 and C4 vertebrae, resulting in block vertebra (Klippel- Feil syndrome Type 1) and unfused spinous process of C6 vertebra.This case report is the first case, where hypertrophied lamina and spinous process of C6 with unfused spinous processes and block vertebra, congenital cervical anomalies were seen in the same patient. Keywords : Spine, Congenital abnormality, Computed tomography, Vertebral schisis.

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