Preliminary Diagnosis: Pharyngitis
I. What imaging technique is first-line for this diagnosis?
- CT soft tissue of the neck with contrast.
- Pharyngitis is a clinical diagnosis. However, imaging may aid in diagnosis or evaluate for secondary complications.
II. Describe the advantages and disadvantages of this technique for diagnosing pharyngitis.
Advantages
- Highly sensitive and specific in diagnosing infection and inflammation of the pharyngeal soft tissues.
- Highly sensitive and specific in evaluating for any underlying primary process of the pharyngeal mucosa and soft tissues of the neck or any secondary complications from a primary pharyngeal inflammatory process, i.e., abscess, cellulitis, or phlegmon formation.
Disadvantages
- Exposes patients to ionizing radiation.
III. What are the contraindications for the first-line imaging technique?
May be contraindicated in pregnant patients.
IV. What alternative imaging techniques are available?
MR of the neck with contrast
V. Describe the advantages and disadvantages of the alternative techniques for diagnosing pharyngitis.
MR of the neck with contrast
Advantages
- Does not expose patients to ionizing radiation.
- More sensitive to subtle soft tissue or osseous edema not appreciated on CT imaging.
Disadvantages
- Expensive.
- Time consuming.
- Requires significant patient cooperation to minimize motion artifact.
- MR imaging offers less detail of the soft tissues of the neck and less differentiation of adjacent vascular, soft tissue, lymphatic, or osseous structures as compared to CT.
VI. What are the contraindications for the alternative imaging techniques?
MR of the neck with contrast
- Contraindicated in patients with non-MR compatible hardware.
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