paediatric neck ultrasound: a two-year retrospective study · cystic hygroma. palpable lump, left...
TRANSCRIPT
Pae
dia
tric
ne
ck u
ltra
sou
nd
: a
two
-ye
ar r
etro
spe
ctiv
e s
tud
y J.
Ch
ia, I
. Mo
ort
hy, K
.Ilia
dis
Ro
yal A
lexa
nd
ra C
hild
ren
’s H
osp
ital
B
righ
ton
& S
uss
ex U
niv
ersi
ty H
osp
ital
s N
HS
Tru
st
Wh
y d
id w
e d
o t
his
stu
dy?
iRef
er li
sts
just
tw
o in
dic
atio
ns
for
pae
dia
tric
nec
k u
ltra
son
ogr
aph
y (U
S) :
atra
um
atic
to
rtic
olli
s (P
16
) an
d n
eon
atal
hyp
oth
yro
idis
m (
P2
0).
We
fou
nd
th
at t
his
do
es n
ot
refl
ect
ou
r p
ract
ice.
Th
is s
tud
y ai
med
to
cla
rify
th
e m
ain
ind
icat
ion
s an
d f
ind
ings
in c
hild
ren
att
end
ing
ou
r te
rtia
ry s
ervi
ce, s
ervi
ng
a p
op
ula
tio
n o
f 2
mill
ion
.
Mat
eri
als
and
Met
ho
ds
St
ud
ies
wer
e id
enti
fied
by
sear
chin
g th
e h
osp
ital
Rad
iolo
gy In
form
atio
n S
yste
m (
CR
IS)
for
the
per
iod
7/1
2/2
01
4 -
7/1
2/2
01
6 (
2 y
ears
)
M
icro
soft
Exc
el 2
01
0 u
sed
fo
r d
ata
anal
ysis
Re
sult
s :
Ref
err
als
CY
STIC
HYG
RO
MA
Pal
pab
le lu
mp
, lef
t u
pp
er b
ack.
U
S sh
ow
s a
larg
e w
ell-
def
ine
d a
ne
cho
ic a
rea
in t
he
left
up
pe
r b
ack
MR
I: h
yper
inte
nse
on
T2
we
igh
ted
se
qu
en
ce, h
ypo
inte
nse
on
T1
we
igh
ted
se
qu
en
ce.
The
se a
re c
on
gen
ital
lym
ph
atic
mal
form
atio
ns,
mo
re c
om
mo
nly
en
cou
nte
red
in t
he
n
eck.
May
be
un
i or
mu
lti-
locu
lar.
PER
SIST
ENT
GEN
ERA
LISE
D A
DEN
OPA
THY
Ult
raso
un
d: n
on
spe
cifi
c re
acti
ve n
od
e, w
ith
in
cre
ase
d v
ascu
lari
ty
Mo
rph
olo
gy n
orm
al
His
tolo
gy: Lan
gerhan
’s
cell
his
tio
cyto
sis.
FIB
RO
MA
TOSI
S C
OLL
I
2 m
on
th o
ld b
oy
wit
h a
tw
o w
ee
k h
isto
ry o
f a
firm
nec
k lu
mp
.
Fusi
form
dila
tati
on
of
the
rig
ht
ste
rno
cle
ido
mas
toid
(so
lid
wh
ite
arr
ow
). N
orm
al le
ft s
tern
ocl
eid
om
asto
id (
das
hed
arr
ow
) sh
ow
n f
or
com
par
iso
n.
May
pre
sen
t w
ith
to
rtic
olli
s. S
ligh
tly
com
mo
ner
in m
ale
s.
Re
solv
es
spo
nta
ne
ou
sly.
THY
RO
ID S
TOR
M
Enla
rge
d t
hyr
oid
lob
e
wit
h h
ete
roge
ne
ou
s
ech
ote
xtu
re
Avi
d c
olo
ur
flo
w D
op
ple
r b
ilate
rally
REC
UR
REN
T JU
VEN
ILE
PAR
OTI
TIS
Loss
of
un
ifo
rm e
cho
gen
icit
y
Scat
tere
d r
ou
nd
hyp
o-e
cho
ic a
reas
(
) p
rese
nt
in t
he
con
tral
ate
ral g
lan
d a
lso
.
Clin
ical
pre
sen
tati
on
: R
ecu
rre
nt
feve
r +
mal
aise
(m
ay m
imic
M
um
ps)
Typ
ical
Ind
icat
ion
s
Pers
isti
ng
pal
pab
le
lum
p–
US
for
char
acte
risa
tio
n
G
oit
re
on
ex
amin
atio
n
– U
S fo
rch
arac
teri
sati
on
?
Dra
inab
le c
olle
ctio
n
?
Thro
mb
us
com
plic
atin
g ce
ntr
al
line
inse
rtio
n/p
rio
r to
lon
g te
rm li
ne
inse
rtio
n
Sp
arse
in
form
atio
n p
rovi
ded
on
ref
erra
lfo
rms:
e.g
. sy
mp
tom
du
rati
on
om
itte
d i
n
18
0
case
s,
om
issi
on
o
f fu
ll b
loo
d
cou
nt/
thyr
oid
fu
nct
ion
tes
t re
sult
s.
Se
aso
nal
wo
rklo
ad v
aria
tio
n.
Re
sult
s: F
ind
ings
Ref
ere
nce
s h
ttp
s://
ww
w.ir
efer
.org
.uk/
- M
akin
g th
e b
est
use
of
clin
ical
rad
iolo
gy v
ersi
on
8.0
.1 a
cces
sed
Ju
ne
20
17
h
ttp
s://
my.
stat
dx.
com
/ -
Else
vier
Sta
tDx
acce
ssed
Ju
ne
20
17
G
olr
iz F
, Bis
set
G.S
III,
D’A
mic
o B
, et
al.(
20
17
) A
clin
ical
dec
isio
n r
ule
fo
r th
e u
se o
f u
ltra
sou
nd
in c
hild
ren
pre
sen
tin
g w
ith
acu
te in
flam
mat
ory
nec
k m
asse
s. P
edia
tric
Rad
iolo
gy
47
: 44
2-4
49
Co
ncl
usi
on
s
Th
e m
ajo
rity
of
pae
dia
tric
nec
ku
ltra
son
ogr
aph
y ex
ams
at o
ur
inst
itu
tio
nw
ere
no
rmal
.
W
ith
hin
dsi
ght,
It is
tem
pti
ng
to d
ism
iss
man
y st
ud
ies
as u
nn
eces
sary
, bu
t to
per
form
th
em is
no
t ti
me
-co
nsu
min
g to
the
rad
iolo
gist
, an
d m
ay b
e ve
ryre
assu
rin
g to
pat
ien
ts a
nd
th
eir
fam
ilies
.
U
ltra
sou
nd
is id
eal f
or
char
acte
risi
ng
abn
orm
alit
ies
in c
hild
ren
’s n
ecks
an
do
ften
th
e o
nly
imag
ing
nec
essa
ry. (
No
ion
isin
g ra
dia
tio
n in
volv
ed)
CO
LLEC
TIO
N
Clin
ical
his
tory
: Fir
m 3
inch
left
su
bm
and
ibu
lar
mas
s.
Ult
raso
un
d:
Lym
ph
no
de
absc
ess
N/A
*: D
rain
ed in
th
eatr
e
Oth
er*
: C
ysti
c le
sio
n d
ecre
asi
ng
in s
ize;
No
acu
te f
ind
ing
s (k
no
wn
cys
tic
hyg
rom
a);
Org
an
isin
g m
idlin
e h
aem
ato
ma
dec
rea
sin
g in
siz
e.