Dr. Muhammad Shoyab
Radiodiagnosis
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
Answered by
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Patient's Query
Hello doctor,
I have had a CT scan done and I have not yet received the reports. I have received the images of the reports, but the left side looks different from the right side. I had the third infection of COVID-19, nasal problems, and headaches for three months. I also have a lump on the left side of my gums and throat. My dentist said it was a chronic infection, but they have not seen this CT scan. I have had two antibiotics for the lumps in my gums, and there has been no improvement because the lumps are getting bigger. In addition, my RBC count is low, and I have an infection in my kidneys.
Hello,
Welcome to icliniq.com.
I have reviewed the attached images (attachments removed to protect the patient's identity). There is nothing to be worried about. I request you upload more images related to your condition.
Regarding follow up
Patient's Query
Hi doctor,
Thank you for the reply.
This is the CT (computed tomography) sinus scan. I have had long COVID - 19 headaches constantly and inflammation in the brain and sinuses.
Hi,
Welcome back to icliniq.com.
Thanks for uploading the full image set (attachment removed to protect the patient's identity). I have evaluated them completely and summarise that at present, you have right-sided maxillary sinusitis, left maxillary polyp, and hyperpneumatization of paranasal sinuses. Beginning with hyperpneumatization, it is actually a variant of the normal development process, where the formation of air cells extends further than usual. In your case, there is pneumatization extends into the petrous apices on both sides, the root of the pterygoid process on the left side, as well as into the occipital clivus. Hyperpneumatisation is not a disease by itself, but it can predispose to sinus diseases like sinusitis (or, in some cases, cancer). However, at present, you just got sinusitis, which is seen as a fluid collection in the right maxillary sinus. Other than that, there is a small polyp at the left maxillary opening, which may block the opening and produce headaches also. I do not think any of these findings are related to COVID -19, but perhaps the headache and nasal blockage are aggravated during COVID infection (but not that COVID has produced the polyp or the sinusitis). So, at this stage, I think you can follow the advice of your GP or ENT specialist regarding the management of the sinusitis and the polyp.
Regarding follow up
Patient's Query
Hi doctor,
Thank you for the reply.
The CT sinuses report, which was very good and made a lot of sense due to the headaches. I also have lumps on my left maxillary molar, and you said I have a small polyp at the left maxillary opening. You are very accurate, and I believe the chronic infection lumps in my left maxillary molar are connected to the polyp. I have had an X-ray done, and apparently, I left-leaning from the bottom of my spine up to my head through my neck. I will see the ENT specialist as you told me to. I have a new query. I have attached my CT angiogram. I have had heart pain on the left side. I would like you to take a look at this; I find it interesting you said I have hyperpneumatisation. I have had an X-ray done, and apparently, I have left-leaning from the bottom of my spine right up to my head through my neck.
Hello,
Welcome back to icliniq.com.
It is nice to hear that you found benefit from my previous reply.
Regarding your new query, I find no thrombosis in your pulmonary angiogram up to segmental arteries. Nor is there any haziness or consolidation in the lung parenchyma, which means there is no subtle abnormality either. So, that means that your chest pain is not due to lung disease. However, the evaluation would have been more accurate if I could get a coronal reconstruction of the images with maximum intensity projection (MIP). Regarding what you mentioned about spinal curvature, I perceive it is not causing you any significant problems, and there is no identifiable abnormality on the images.
I hope your queries have been clarified. Best wishes.
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Radiodiagnosis
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