There is an ill-defined area of osteolysis interrupting the superficial and deep cortices, in the right mandibular angle deep to the right 2nd molar tooth, extending to the mandibular canal with bone marrow sclerosis and thick periosteal reaction of the right hemimandible. Lysis of the roots of both right lower molar teeth is.
Overlying soft tissue oedema is noted as well as oedema and enlargement of the right masseter muscle.
In keeping with the patient's medical history, appearances are suggestive of bisphosphonate induced osteonecrosis of the jaw.
Multiple enlarged right submandibular lymph nodes, the largest measures 11 mm in short axis. Multiple sub centimetre lymph nodes in both cervical regions.
There is an elongated ovoid dense fluid collection in the right side of the retropharyngeal space measuring 6.7 x 2.8 x 1.3 cm. A small fluid attenuation focus in the right tonsil.