Ludwig Angina — MFDS Part 1 MCQ
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Correct answer: D — Bilateral submandibular and sublingual spaces, plus the submental space
Ludwig angina is a rapidly spreading cellulitis of the floor of the mouth, classically involving both submandibular and sublingual spaces together with the submental space. Bilateral involvement and spread across fascial planes distinguish it from a localised dental abscess. Oedema in the sublingual tissues can elevate and posteriorly displace the tongue, producing life-threatening airway compromise. Parapharyngeal, retropharyngeal, danger and pretracheal spaces may become involved through secondary extension of a severe deep-neck infection but do not define Ludwig angina. Buccal, canine, infratemporal and temporal spaces are associated with other patterns of odontogenic spread. Suspected Ludwig angina therefore requires immediate airway assessment and urgent referral for hospital-based multidisciplinary management.
Reference: Hasan W et al. Ludwig's angina: An alarming radiology challenge. Radiology Case Reports. 2022;17:3103–3107. https://pubmed.ncbi.nlm.nih.gov/35784784/