From the Research
For cricoid cartilage pain, computed tomography (CT) of the neck with contrast is the recommended initial imaging study. This provides detailed visualization of the cartilaginous structures of the larynx, surrounding soft tissues, and can identify potential causes such as trauma, inflammation, infection, or neoplastic processes affecting the cricoid cartilage, as seen in a case report of a unique presentation of cricoid cartilage fracture causing intermittent dyspnea without preceding trauma 1.
Key Considerations
- MRI may be considered as a complementary study if soft tissue pathology is suspected or if CT findings are inconclusive.
- Ultrasound can be useful as a preliminary screening tool, particularly for superficial lesions or to guide aspiration procedures.
- Plain radiographs have limited utility for cricoid cartilage evaluation due to overlapping structures and poor soft tissue contrast.
- The choice of imaging should be tailored to the clinical presentation, with CT being preferred for acute trauma or suspected fracture, while MRI might be more appropriate for evaluating cartilage edema or early chondritis, as highlighted in a study on the measurement of cross-sectional dimensions of the cricoid cartilage 2.
Clinical Context
Prompt imaging is particularly important when symptoms are accompanied by voice changes, difficulty breathing, or swallowing problems, as these may indicate more serious underlying pathology requiring urgent intervention, such as an isolated comminuted fracture of the cricoid cartilage and narrowing of the airway after a traumatic blunt injury of the neck 3.
Treatment Implications
The diagnosis and treatment of cricoid cartilage fractures can be complex, and surgical management may be necessary in some cases, such as isolated cricoid fracture causing arytenoid immobility 4. However, conservative treatment may also be effective in certain cases, as seen in a report of a patient with an isolated comminuted fracture of the cricoid cartilage who was treated conservatively with oxygen therapy and silence therapy 3.
Imaging Recommendations
CT of the neck with contrast is the preferred initial imaging study for evaluating cricoid cartilage pain, due to its ability to provide detailed visualization of the cartilaginous structures and surrounding soft tissues, as well as its sensitivity in detecting potential causes such as trauma, inflammation, infection, or neoplastic processes, as demonstrated in a case report of a novel management of an isolated comminuted cricoid cartilage fracture 5.