Eustachian tube calcification as an unusual finding on a panoramic radiograph

The author herein presents an unusual case of eustachian tube calcification masquerading as loose radiopacities in the temporomandibular joints on a panoramic image, creating a diagnostic challenge. The patient, a 72-year-old woman, presented to the dental service for implant treatment to improve her masticatory function. A cone-beam computed tomography scan was performed and reviewed by a board-certified oral and maxillofacial radiologist. The scan showed no evidence of calcifications in the temporomandibular joints; however, it revealed nodular calcifications within the cartilaginous portion of the eustachian tube bilaterally. Additionally, this report briefly reviews the differential diagnosis of calcified loose bodies in the temporomandibular joint and provides information that needs to be reinforced periodically.