Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Section 3 Thorax
- Section 4 Cardiovascular
- Section 5 Abdomen
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Case 89 Thymus simulating mediastinal hematoma
- Case 90 Foreign body aspiration
- Case 91 Idiopathic ileocolic intussusception
- Case 92 Ligamentous laxity and intestinal malrotation in the infant
- Case 93 Hypertrophic pyloric stenosis and pylorospasm
- Case 94 Retropharyngeal pseudothickening
- Case 95 Cranial sutures simulating fractures
- Case 96 Systematic review of elbow injuries
- Case 97 Pelvic pseudofractures: normal physeal lines
- Case 98 Hip pain in children
- Case 99 Common pitfalls in pediatric fractures: ones not to miss
- Case 100 Non-accidental trauma: neuroimaging
- Case 101 Non-accidental trauma: skeletal injuries
- Index
- References
Case 94 - Retropharyngeal pseudothickening
from Section 8 - Pediatrics
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Section 3 Thorax
- Section 4 Cardiovascular
- Section 5 Abdomen
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Case 89 Thymus simulating mediastinal hematoma
- Case 90 Foreign body aspiration
- Case 91 Idiopathic ileocolic intussusception
- Case 92 Ligamentous laxity and intestinal malrotation in the infant
- Case 93 Hypertrophic pyloric stenosis and pylorospasm
- Case 94 Retropharyngeal pseudothickening
- Case 95 Cranial sutures simulating fractures
- Case 96 Systematic review of elbow injuries
- Case 97 Pelvic pseudofractures: normal physeal lines
- Case 98 Hip pain in children
- Case 99 Common pitfalls in pediatric fractures: ones not to miss
- Case 100 Non-accidental trauma: neuroimaging
- Case 101 Non-accidental trauma: skeletal injuries
- Index
- References
Summary
Imaging description
Initial imaging evaluation for retropharyngeal abscess consists of a lateral radiograph of the cervical soft tissues. In the setting of either retropharyngeal abscess or cellulitis, there is usually marked thickening of the prevertebral soft tissues. The degree of thickening typically exceeds 50% of the anterior-posterior (AP) diameter of the adjacent vertebral body (Figure 94.1) [1]. In severe cases there may be anterior displacement of the airway and/or loss of normal cervical lordosis due to soft tissue expansion. Identification of soft tissue gas is the only method to distinguish abscess from cellulitis alone on radiography. Sensitivity and specificity of lateral neck radiography for retropharyngeal abscess has been reported to be 80% and 100%, respectively [2].
Pseudothickening of the cervical soft tissues results from neck flexion, expiration, or swallowing during radiography. This entity is particularly common in infants and young children, where the neck is short [3]. There is apparent widening of the pre-vertebral soft tissues that mimics abscess or cellulitis (Figure 94.2).
- Type
- Chapter
- Information
- Pearls and Pitfalls in Emergency RadiologyVariants and Other Difficult Diagnoses, pp. 338 - 340Publisher: Cambridge University PressPrint publication year: 2013
References
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