Identification of peritonsillar abscess by transcutaneous cervical ultrasound

Intraoral evaluation with ultrasound has been shown to be an ideal method for differentiating between peritonsillar abscess (PTA) and peritonsillar cellulitis. Unfortunately, many patients experience significant trismus and are unable to tolerate the intracavitary probe. Evaluation of the submandibular space with a high frequency linear transducer from the external aspect of the neck affords an alternative technique that has been shown to have high specificity for PTA. Unfortunately, there are no reported cases in the emergency medicine literature detailing this novel technique. We present a case of a 30 year old male patient with severe throat pain and trismus. Ultrasound evaluation of the submandibular space with a linear transducer demonstrated a clear peritonsillar abscess and allowed for successful aspiration of 5 mLs of purulent material.