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Yes, yes it is another scary neck case!

March 12, 2015 1 Comment

Look, we know you are probably tired of hearing us tell you about all the things you can find with POCUS that are missed on physical exam or other imaging modalities.

Well too bad!  Learn this stuff and make a big save yourself!

Lloyd Gordon has another nice case involving the neck…[ed.]

 

This fellow was a handover for a CT of the neck. He had a big tender mass around the angle of the jaw.

Lymph_JDG

 

 

Lymph_Abcess

 

POCUS easily showed an enlarged JDG (jugulodigastric?  ed.) lymph node with high flow and abscess formation.

Lymph_Flow

 

As you can see, the carotid is very close.

Lymph_Carotid

I let the ENT do the I&D!

 

The CT scan was reported as normal although I could see the enlarged JDG node and early degeneration/abcess since I knew what to expect from the POCUS exam.

Lymph_CT

I was surprised that the CT in this case added little except some radiation.

(The take home point is that no single imaging modality is 100% specific or sensitive.  Clinical acumen, considering alternate tests, and calling in more help is the right way to go when in doubt. ed.)

 

Comments (1)

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  1. Lloyd Gordon says:

    Sorry about the “JDG”-I did mean Jugulodigastric lymph node.

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