Peritonsillar abscess Ultrasound
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Prince Tano Djan, BSc, MBChB [2]
Overview
The diagnosis of peritonsillar abscess may be made without the use of imaging however, imaging options may help in differentiating peritonsillar abscess from other simialr conditions example, peritonsillar cellulitis, retropharyngeal abscess and epiglottitis. On ultrasound [1]peritonsillar abscess appears as focal irregularly marginated hypoechoic area.[2][3][4][1]
Ultrasound
The diagnosis of peritonsillar abscess may be made without the use of imaging however, imaging options may help in differentiating peritonsillar abscess from other simialr conditions example, peritonsillar cellulitis, retropharyngeal abscess and epiglottitis.
This is helpful in differentiating peritonsillar abscess from peritonsillar cellulitis as well as a guide during abscess drainage. The approach may be intraoral or submandibular.[5][2][6][7][8]
On ultrasound the following may be found:[4][1][2][3][4][1]
- Peritonsillar abscess appears as focal irregularly marginated hypoechoic area.
- Irregular hypoechoic areas within the tonsil may represent pockets of developing purulence or necrosis called intratonsillar abscesses.
- Peritonsillar cellulitis appears as enlarged tonsil with ill-defined margins and markedly increased echogenicity of surrounding soft tissues that suggests significant inflammatory change/cellulitis.
References
- ↑ 1.0 1.1 1.2 1.3 Boesen T, Jensen F (1992). "Preoperative ultrasonographic verification of peritonsillar abscesses in patients with severe tonsillitis". Eur Arch Otorhinolaryngol. 249 (3): 131–3. PMID 1642863.
- ↑ 2.0 2.1 2.2 Bandarkar AN, Adeyiga AO, Fordham MT, Preciado D, Reilly BK (2016). "Tonsil ultrasound: technical approach and spectrum of pediatric peritonsillar infections". Pediatr Radiol. 46 (7): 1059–67. doi:10.1007/s00247-015-3505-7. PMID 26637999.
- ↑ 3.0 3.1 Scott PM, Loftus WK, Kew J, Ahuja A, Yue V, van Hasselt CA (1999). "Diagnosis of peritonsillar infections: a prospective study of ultrasound, computerized tomography and clinical diagnosis". J Laryngol Otol. 113 (3): 229–32. PMID 10435129.
- ↑ 4.0 4.1 4.2 Lyon M, Blaivas M (2005). "Intraoral ultrasound in the diagnosis and treatment of suspected peritonsillar abscess in the emergency department". Acad Emerg Med. 12 (1): 85–8. doi:10.1197/j.aem.2004.08.045. PMID 15635144.
- ↑ Costantino TG, Satz WA, Dehnkamp W, Goett H (2012). "Randomized trial comparing intraoral ultrasound to landmark-based needle aspiration in patients with suspected peritonsillar abscess". Acad Emerg Med. 19 (6): 626–31. doi:10.1111/j.1553-2712.2012.01380.x. PMID 22687177.
- ↑ Buckley AR, Moss EH, Blokmanis A (1994). "Diagnosis of peritonsillar abscess: value of intraoral sonography". AJR Am J Roentgenol. 162 (4): 961–4. doi:10.2214/ajr.162.4.8141026. PMID 8141026.
- ↑ Strong EB, Woodward PJ, Johnson LP (1995). "Intraoral ultrasound evaluation of peritonsillar abscess". Laryngoscope. 105 (8 Pt 1): 779–82. doi:10.1288/00005537-199508000-00002. PMID 7630286.
- ↑ Blaivas M, Theodoro D, Duggal S (2003). "Ultrasound-guided drainage of peritonsillar abscess by the emergency physician". Am J Emerg Med. 21 (2): 155–8. doi:10.1053/ajem.2003.50029. PMID 12671820.