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Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
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Interactive Transcript
Report
Patient History
Fever. Left-sided throat pain.
Findings
Contrast-enhanced CT of the neck demonstrates an extensive abnormality involving the left oropharynx which partially effaces the adjacent airway. There is diffuse soft tissue swelling of the left tonsil that extends superiorly to involve the soft palate and left half of the nasopharynx. The involvement of the soft palate extends medially to involve the tip of the uvula. The diffuse edema extends inferiorly to involve the left glossotonsillar sulcus, left pharyngoepiglottic fold and left piriform sinus. The involvement of the left pharyngoepiglottic fold appears to extend medially to involve the free margin of the epiglottis. There are some focal areas of low attenuation involving the left tonsillar region that extend to the soft palate that could represent early abscess. However, this may also represent a substantial amount of phlegmon. There is some edema involving the retropharyngeal space.
There are multiple prominent lymph nodes seen throughout both sides of the neck. The largest measures approximately 1.7cm and left level 2.
Visualized portion of the brain is within normal limits. Visualized portion of the lungs are within normal limits.
Conclusions
1. Diffuse soft tissue abnormality likely representing extensive phlegmon partially effacing the airway that is centered in the left tonsil that extends superiorly to involve the left half of the nasopharynx and inferiorly to involve the left glossal tonsillar sulcus and piriform sinus. There is associated involvement of the uvula and free margin of the epiglottis. There are some subtle focal areas of low attenuation within this large soft tissue abnormality that could represent early abscess. However, it is possible this also represents diffuse soft tissue phlegmon and early suppuration without the formation of well-defined abscess.
2. Multiple prominent lymph nodes the largest of which measures 1.7cm and left level 2.
Case Discussion
Faculty
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
Suresh K Mukherji, MD, FACR, MBA
Clinical Professor, University of Illinois & Rutgers University. Faculty, Michigan State University. Director Head & Neck Radiology, ProScan Imaging
Tags
Neuroradiology
Head and Neck
CT
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