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Silver Nitrate Interpreted as Osseous Pathology on Radiographs

Two Case Reports

Jared Clifford Private practice, PMH Surgical Group, PMH Medical Center, 820 Memorial St, Suite 3, Prosser, WA 99350 ( jclifford@pphdwa.org).

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Silver nitrate is often used topically for hemostasis. When radiography is performed after the application of silver nitrate, an artifact appears on the radiograph that may be mistaken for an abnormal calcification or a foreign body. The patients in the following two cases were treated with topical silver nitrate. In each case, radiographs taken after treatment seemed to demonstrate abnormal soft-tissue calcifications in the area of silver nitrate application. Subsequent clinical examination revealed no calcifications, and it was determined that the abnormal radiographic findings were silver nitrate artifacts. Although this phenomenon has been described in the medical literature, misdiagnosis still occurs and could potentially lead to additional imaging or unnecessary procedures.