Retropharyngeal soft tissue swelling

Case contributed by Tim Luijkx
Diagnosis probable


6 days fever, right side neck pain and sternocleidomastoid pain, difficulty opening jaw. Retropharyngeal abscess versus lymphadenitis with or without abscess?

Patient Data

Age: 5-10 years

Swelling of the prevertebral soft tissues, given the clinical history highly suspicious of retropharyngeal pathology.

Annotated image

Prevertebral soft tissue swelling indicated in yellow. Expected prevertebral soft tissue delineation indicated by dotted orange line.

Case Discussion

In the pediatric population prevertebral swelling can be mimicked by crying and/or increased neck flexion. In this case, however, the swelling seems too large to be explained by these factors and the clinical details are concerning for retropharyngeal pathology.

The presumed clinical diagnosis was one of a retropharyngeal abscess.

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