How is a PA granuloma identified?

A PA granuloma, or periapical granuloma, is typically associated with the apex of a non-vital tooth, and it is identified as a radiolucent area on radiographic images. This radiolucency indicates the presence of inflammation and bone resorption due to the body’s response to infection at the root tip. The asymptomatic nature of many PA granulomas is significant; they often do not present noticeable symptoms, which can make detection dependent on radiographic examination rather than clinical signs. The location at the apex of a non-vital tooth further supports the diagnosis, as this is a common outcome when there is necrosis of the pulp. The contrast with other conditions noted in the choices is important because a vital tooth typically would not present with such a lesion, and normal bone density should not show any radiolucency.