title: Transcervical ultrasonography in the diagnosis of pediatric peritonsillar abscess.
abstract: OBJECTIVE
  Pediatric peritonsillar abscess (PTA) is a common infection, particularly in the adolescent population. Physical examination alone is not always sufficient to diagnose this pathology, and thus, computed tomography is often utilized as a diagnostic adjunct. With growing concern over radiation exposure in the pediatric population, we conducted a prospective study to investigate the use of ultrasonography in the detection of pediatric PTA.
  
  
  METHODS
  Prospective single arm cohort study.
  
  
  METHODS
  Pediatric patients examined in consultation for concern for PTA were prospectively enrolled in the study. Patients were managed based on clinical symptoms and presentation. Transcervical ultrasonography of the peritonsillar region was performed on all patients. Clinical outcomes were reviewed retrospectively and compared to ultrasound findings.
  
  
  RESULTS
  Forty-three patients (age range, 2-20 years) were enrolled in the study. The sensitivity and specificity of transcervical ultrasound when compared to clinical outcomes were 100% and 76.5%, respectively. The positive and negative predictive values were 52.9% and 100%, respectively. Fisher exact test showed a statistically significant association (P < .01) between negative ultrasonography and successful medical management, and multivariate regression analysis showed a strong correlation between ultrasound findings and presence/absence of purulence during surgical intervention (P = .01).
  
  
  CONCLUSIONS
  Transcervical ultrasonography is a useful tool in diagnosing pediatric PTA. This imaging modality not only avoids undue radiation exposure, but it also proves to be an excellent tool at identifying patients who will not need surgical intervention. To our knowledge, this is the first study to explore this technique for the diagnosis of pediatric PTA.
  
  
  METHODS
  2b.
authors.affiliation: Department of Pediatric Otolaryngology, Children's National Health System, Washington, DC, U.S.A.
authors.forename: M Taylor
authors.initials: MT
authors.lastname: Fordham
authors.affiliation: George Washington University School of Medicine, Washington, DC, U.S.A.
authors.forename: Alex N
authors.initials: AN
authors.lastname: Rock
authors.affiliation: Department of Radiology, Children's National Health System, Washington, DC, U.S.A.
authors.forename: Anjum
authors.initials: A
authors.lastname: Bandarkar
authors.affiliation: Department of Pediatric Otolaryngology, Children's National Health System, Washington, DC, U.S.A.
authors.forename: Diego
authors.initials: D
authors.lastname: Preciado
authors.affiliation: Department of Pediatric Otolaryngology, Children's National Health System, Washington, DC, U.S.A.
authors.forename: Michelle
authors.initials: M
authors.lastname: Levy
authors.affiliation: Department of Emergency Medicine, Children's National Health System, Washington, DC, U.S.A.
authors.forename: Joanna
authors.initials: J
authors.lastname: Cohen
authors.affiliation: Department of Radiology, Children's National Health System, Washington, DC, U.S.A.
authors.forename: Nabile
authors.initials: N
authors.lastname: Safdar
authors.forename: Brian K
authors.initials: BK
authors.lastname: Reilly
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D010372:Pediatrics; D000039:Peritonsillar Abscess / Q000175:diagnosis / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D055815:Young Adult
keywords: Pediatric peritonsillar abscess; pediatric head and neck infection; transcervical; ultrasound