Question

A 45- year old patient complained of pain in one side of the neck. She is afraid of eating food as it worsens the pain. Ultrasound imaging of the salivary glands is done and shown below. What is the most likely diagnosis?

• A. Sialolithiasis
• B. Foreign body
• C. Osteoma of the floor of the mouth
• D. Cervical lymphadenopathy

Answer 1

The Correct Option is A

The most likely diagnosis for the case described is Sialolithiasis. Here's the reasoning:

• Symptoms: The patient, a 45-year-old, experiences unilateral neck pain. This pain increases while eating, likely due to the stimulation of salivary flow that a stone obstructs, typical in sialolithiasis.
• Ultrasound Imaging: Ultrasound is a common diagnostic tool for identifying salivary gland stones. The image would depict hyperechoic (bright) focus with posterior acoustic shadowing indicative of a stone in the gland or duct.
• Exclusion of Other Options:
  • Foreign body: Usually leads to acute symptoms related to inhalation or ingestion, not chronic neck pain worsened by eating.
  • Osteoma of the floor of the mouth: While it can cause issues with oral function, it often presents differently and wouldn’t typically cause the specific type of neck pain described.
  • Cervical lymphadenopathy: This condition involves lymph node enlargement, which does not directly correlate with increased pain upon eating as seen here.

Given the symptoms and procedure, sialolithiasis is the most plausible and fitting diagnosis.