The radio-opacity of fishbones: a cadaveric study

Area of Science:

• Radiology
• Otolaryngology
• Forensic Science

Background:

• Impacted fishbones in the neck present a diagnostic challenge.
• Lateral neck radiographs are commonly used but have limited sensitivity for fishbone localization.
• Variations in fishbone radio-opacity may contribute to poor visualization.

Purpose of the Study:

• To evaluate the sensitivity of lateral neck radiography for detecting fishbones.
• To determine if fishbone radio-opacity or position influences visualization.
• To assess the utility of routine radiography for fishbone impaction.

Main Methods:

• A cadaver head and neck were used with fishbones from 10 species introduced into the vallecula and hypopharynx.
• Lateral radiographs were taken after fishbone introduction.
• Radiographs were independently reviewed by a radiologist and otolaryngologist.

Main Results:

• All fishbone species were visible on radiographs, with only one bone missed by both observers.
• Visualization of fishbones was found to be more dependent on their position than their radio-opacity.
• No inter-observer variation was noted in the review of the radiographs.

Conclusions:

• Lateral neck radiography can effectively visualize fishbones when properly positioned.
• Fishbone position is a more critical factor than radio-opacity for radiographic detection.
• Routine radiography is recommended for suspected fishbone impaction.