Incidental Findings of Muscle-Origin Calcifications in the Sternocleidomastoid Muscle on an Orthopantomogram: a Case Report

Background: This case report documents incidental findings of bilateral calcifications within the sternocleidomastoid (SCM) muscle observed on a dental panoramic radiograph. The aim is to emphasize the importance of recognizing overlapping anatomical structures in panoramic radiography to prevent misdiagnosis. Methods: During a routine dental examination, a 59-year-old female was found to have multiple small calcifications bilaterally in the mandibular ramus region on an orthopantomogram. Further evaluation with ultrasound confirmed the presence of calcifications within the SCM muscle. A comprehensive differential diagnosis was performed, considering potential causes such as trauma, inflammation, metabolic disorders, and idiopathic conditions. Results: Ultrasound imaging identified multiple small calcified deposits within the SCM muscle bilaterally, with sizes ranging from 2 to 6 mm. The absence of systemic disorders or recent trauma supported a diagnosis of dystrophic calcifications. Conclusions: This case highlights the need to assess anatomical structures beyond the dental region in panoramic imaging. Ultrasound is recommended as an adjunct imaging modality to accurately determine the origin and location of muscle calcifications without additional radiation exposure. Recognizing these incidental findings on dental radiographs is essential for avoiding misinterpretation and unnecessary interventions.