Related Experiment Video
Updated: Feb 11, 2026
Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
Published on: September 8, 2023
Pediatric lateral neck infections - Computed tomography vs ultrasound on initial evaluation
Nicholas A Quinn1, Jared A Olson2, Jeremy D Meier1
1Department of Surgery, Division of Otolaryngology, 50 N Medical Drive, University of Utah, Salt Lake City UT 84132, USA; Primary Children's Hospital, Salt Lake City, UT 84113, USA.
Insights
Initial imaging for pediatric lateral neck infections with ultrasound or computed tomography did not affect hospital stay or cost. However, computed tomography identified coexisting retropharyngeal infections missed by ultrasound, highlighting the need for imaging guidelines.
Area of Science:
- Pediatric Infectious Diseases
- Medical Imaging
- Otolaryngology
Background:
- Deep lateral neck infections in children require prompt diagnosis and management.
- The choice of initial imaging modality can influence diagnostic accuracy, patient outcomes, and healthcare costs.
Purpose of the Study:
- To evaluate the impact of initial imaging modality (ultrasound vs. computed tomography) on outcomes and costs in pediatric patients with deep lateral neck infections.
Main Methods:
- A retrospective case series of pediatric patients (<18 years) admitted with lateral neck infections between January 2014 and May 2016.
- Patients were categorized based on initial imaging: primary ultrasound or primary computed tomography.
- Outcomes compared included length of stay, additional imaging, procedures, readmission rates, and hospital costs.
Main Results:
- No significant difference in length of stay or hospital costs between primary ultrasound and computed tomography groups.
- Computed tomography identified retropharyngeal infections in 10% of cases, which were not detected with initial ultrasound.
- Additional imaging was more frequent in the primary ultrasound group (43% vs. 20%).
Conclusions:
- Initial imaging modality for pediatric lateral neck infections does not significantly impact length of stay or cost.
- Computed tomography is superior in detecting concurrent retropharyngeal infections.
- Further research is needed to establish optimal imaging protocols for pediatric lateral neck infections.
Objective:
Review the evaluation of children with a deep lateral neck infection and define the impact of initial imaging modality on outcomes and costs.
Method:
Case series, pediatric patients <18 years of age admitted to a tertiary care hospital with lateral neck infection between 01/01/14-05/31/16 as identified by ICD-9 and ICD-10 codes: 289.3 (lymphadenitis, unspecified), 682.1 (cellulitis and abscess of neck), 683 (acute lymphadenitis), I88.9 (nonspecific lymphadenitis, unspecified), L02.11 (cutaneous abscess of neck), L03.221 (cellulitis of neck), and L03.222 (acute lymphangitis of neck). Patients were divided into two groups based on initial imaging modality: primary ultrasound or primary computed tomography. Differences in length of stay, type and total number of imaging studies obtained, number of procedures, hospital readmission, and hospital cost were compared between cohorts.
Results:
There were 40 (31%) primary ultrasound and 88 (69%) primary computed tomography patients (128 total). Median length of stay was 46 (IQR: 25,90) hours (1.9 days) for primary ultrasound and 63 (IQR: 39,88) hours (2.6 days) for primary computed tomography patients (p = 0.33). Drainage was performed in 48% of both groups. Additional imaging occurred in 17 (43%) primary ultrasound and 18 (20%) primary computed tomography patients (p = 0.02). Readmission occurred in 8 patients (6.3%). Retropharyngeal infection was encountered in 13 patients (10%); this was only discovered in patients who had a computed tomography performed. Median cost per primary ultrasound patients was $5363 (IQR: 3011, 7920) and $5992 (IQR: 3450, 8060) for primary computed tomography patients.
Conclusions:
The primary imaging modality (ultrasound or computed tomography) used to work-up children with a lateral neck infection did not impact length of stay or hospital cost. However, a significant subset had a coexisting retropharyngeal infection that was only identified on computed tomography. Future studies are needed to identify appropriate criteria for imaging in the work-up of lateral neck infections.
More Related Videos
12:32Image Rendering Techniques in Postmortem Computed Tomography: Evaluation of Biological Health and Profile in Stranded Cetaceans
Published on: September 27, 2020
12:24Computed Tomography-guided Time-domain Diffuse Fluorescence Tomography in Small Animals for Localization of Cancer Biomarkers
Published on: July 17, 2012
Related Concept Videos
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
01:27Imaging Studies III: Computed Tomography
02:33Initiation of Translation
First, the initiator tRNA must be selected from the pool of elongator tRNAs by eukaryotic initiation factor 2 (eIF2). The initiator tRNA (Met-tRNAi) has conserved sequence elements including modified bases at...
02:33Initiation of Translation
01:26Muscles of the Anterior Neck
01:26Arteries of the Head and Neck
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...