Peritonsillar abscess

Preliminary Diagnosis: Peritonsillar abscess

I. What imaging technique is first-line for this diagnosis?

• CT soft tissue neck with contrast

II. Describe the advantages and disadvantages of this technique for diagnosis of peritonsillar abscess.

Advantages

• Relatively inexpensive, fast imaging modality.

• Able to differentiate neck pathology from adjacent vascular structures, lymph nodes, and osseous structures with great specificity and sensitivity.

• Delineates extension of inflammatory process into different spaces of the neck

Disadvantages

• Exposes patients to ionizing radiation

  Related Content

• Less sensitive and specific for detailing any subtle edema in the adjacent osseous structures to suggest early osteomyelitis

III. What are the contraindications for the first-line imaging technique?

• May be contraindicated in pregnant patients

IV. What alternative imaging techniques are available?

• Contrasted MR of the neck

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of peritonsillar abscess.

Contrasted MR of the Neck

Advantages

• Does not expose the patient to ionizing radiation.

• More sensitive to detecting early surrounding osseous edema to suggest secondary osteomyelitis

Disadvantages

• Less adept in detailing and differentiating the soft tissue pathology from adjacent vascular structures, lymph nodes, and osseous structures

• Expensive

• Time consuming

• Requires significant patient cooperation to minimize motion artifact

VI. What are the contraindications for the alternative imaging techniques?

Contrasted MR of the Neck

• Contraindicated in patients with non–MR-compatible hardware

Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.

No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.