• Study performed:  An MRI of the head was performed (0.4T, Hitachi). The following sequences are provided: Transverse T2, T2*, FLAIR, T1 pre- and post-contrast; sagittal T2, T1 post-contrast and dorsal STIR, T1 pre- and post-contrast sequences. Additionally, transverse and dorsal subtraction images are available.
• Findings:
  Large thick walled structure within the right aspect of the oral cavity with T2 hyperintense and T1 hypointense center, crossing the midline.
  Hyperintensity of the temporalis, masseter and pytergoid musculature
  Centrally hypointense, surrounded by a hyperintense rim, linear structure within the right pytergoid musculature
  Marked lateral displacement of the right globe
  Swelling of the right eyelid
  Hyperintensity of the right rostroventral calvarium
  Thickening and contrast enhancement of the right sided meninges and secondary compression of the right cerebrum
  T2 hyperintense material within the right tympanic bulla
  Retropharyngeal, parotic and mandibular lymph node enlargement and contrast enhancement
  Enlargement and contrast enhancement of the zygomatic, mandibular and parotid salivary glands.

• Conclusions:
  Large intraoral abscess
  Foreign material in the right pytergoid muscle
  Right sided multifocal myosistis
  Right rostroventral osteomyelitis of the calvarium
  Right sided menigitis
  Right sided otitis media
  Right sided reactive lymphadenopathy and sialodenitis
  Secondary osteomyelitis
• An ultrasound was performed to confirm the presence of the foreign body (image attached shown by asterisk). The foreign body was removed and the patient treated with a long course of antibiotics.

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