Head and Neck Ultrasound for Acute Admissions and in the Lump Clinic

Abstract

Ultrasound has an important role in the assessment of neck lumps. It provides a safe and quick imaging modality which offers high-resolution images as an adjunct to targeted biopsy. The application of ultrasound in the head and neck has several benefits but also key limitations. It is a dynamic study heavily dependent on the operator’s skill and knowledge. Interpretation of the ultrasound report also requires an understanding of the basic physics underpinning the use of ultrasound, particularly pertaining to the interpretation of different tissue types. Recognising the imaging findings of infection and inflammation will be reviewed, including recommendations for differentiating benign and malignant lesions, and in particular benign and malignant lymph nodes. Benign causes of neck lumps, which will also be discussed, include lipomas, branchial cleft cysts and thyroglossal duct cysts. Throughout the chapter, the role of intervention in diagnosis or in symptomatic relief is also considered.