Purpose or Case Report: Children often present to the emergency room (ER) with painful neck swelling, sore throat, and difficulty breathing. Careful clinical examination and good communication with pediatric physicians help plan the appropriate imaging workup for such pediatric patients. Knowing the various imaging appearances of the many encountered disorders of the neck in children further helps diagnose and plan the most appropriate management.
Methods & Materials: Our exhibit will review the common pathological entities of the neck in the pediatric population encountered in the emergency department and will illustrate their classic imaging features. We will briefly discuss the normal anatomy of the neck to understand how the location and imaging configuration of pathology helps in the differential diagnosis.
Results: Radiological assessment of emergent pediatric neck pathologies is tailored based on clinical presentation, physical examination, and clinical suspicion. Imaging aims to help arrive at a diagnosis and, if not, to limit differential efficiently. Plain radiographs are helpful, especially for acute epiglottis, croup, radiopaque foreign body, and retropharyngeal abscesses. Ultrasound is the initial imaging investigation in most cases because of its easy availability and real-time imaging. Because of its multiplanar capabilities and no sedation requirement, CT is frequently performed in equivocal and challenging cases. MRI, though it provides better soft tissue characterization, is rarely performed in an emergency. Radiologists should help decide which modality to go for based on multiple factors, including clinical suspicion and the patient's age.
Conclusions: Clinical history, physical exam, and good communication with pediatric physicians help plan the appropriate imaging workup of pediatric patients presenting with a neck-related pathology. Knowledge of the various imaging appearances of the commonly encountered ER pathologies of the pediatric neck further helps diagnose and plan the most appropriate management.