Normal neck ultrasound

Case contributed by Derek Smith

Presentation

Right submandibular discomfort. No masses palpable.

Patient Data

Age: 35 years
Gender: Female
ultrasound

Normal ultrasound findings using high frequency linear probe. Regions include:

  • level 1a between digastric muscles
  • thyroid isthmus
  • both thyroid lobes (which includes carotid and jugular bulb)
  • submandibular glands (can be followed from midline - submandibular hilum sits just above myelohyoid)
  • parotid glands (focus can be dropped to inspect deep lobes)
  • level 2 to hyoid (including jugulodigastric nodes which can be up to 15 mm in normal circumstances)
  • level 3 from hyoid to cricoid
  • level 4 from cricoid to clavicles
  • level 5 from posterior border of sternocleidomastoid

Case Discussion

Ultrasound is an extremely useful modality to review the neck, and is an essential adjunct in tissue sampling / biopsy.

Having a well rehearsed routine is important to avoid missing regions, and also to familiarise yourself with the terminology of nodal levels in particular.

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