Modified Mondays: Anatomy Anomaly

Ask any Radiologist, they’ll tell ya: you have to know what a structure is SUPPOSED to look like, or you’ll never know when it looks wrong. In this clip, pay particular attention to the base of tongue. If you know what a normal base of tongue looks like, you will notice that this patient’s is quite full. It’s especially noticeable around 16 seconds in.

This patient was complaining of feeling pain and difficulty with swallowing, especially with solids. Once the soft tissue fullness at the base of tongue was noted, we recommended an ENT referral, which was completed. It turned out to be some residual edema from a recent traumatic self-extubation (note-the patient had a trach in place by the time the MBS was completed-we found out later the acute care team decided to trach the patient since the self-extubation was so traumatic). Great example of how knowing what you are looking at during a modified can improve the patient care, even when the patient has a generally nice swallow, like this one. 

PS This is also great imaging of the thyroid cartilage, but that’s another topic for another week.