Even after almost 20 years of completing MBS studies, every once in a while I have no idea what I’m looking at. I could just play it cool and fake it till I make it (or until I get myself to Google), but I have found honesty, and asking for help, to be the best policy. At the time, my most interesting guess was a piece of shrimp (Spoiler: it was not a piece of shrimp).
In acute care, when I had easier access to Radiologists, I would often ask them to look at videos for me when I wasn’t sure, sometimes even standing outside their office door. Once they figured out I wouldn’t go away, they would always take a look. I’m sure they found me annoying, but I survived, and I learned quite a bit from them, which meant better care for my patients.
As a mobile MBS SLP, I don’t often have personal access to Radiologists (we send our studies to a group at the end of the day), but that night happened to be our company Christmas party, and we had invited our partner Radiologist. Laptop in hand, I chatted him up at the party and found out pretty quickly that the patient had a calcified lymph node. Lymph nodes in the neck can become calcified due to chronic inflammation, or in response to an infection. They are usually asymptomatic, and don’t tend to have an effect on the swallow, as was the case here. They would still warrant a referral (either to primary care physician or ENT) since it’s a good idea to find out the underlying cause.