Neck Soft Tissue

Review article at Radiographics

Imaging Acute Airway Obstruction in Infants and Children


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Normal Prevertebral Soft-Tissue Thickness

Increased Prevertebral Soft-Tissue 

Epiglottitis


Exudative tracheitis

Increased density of the subglottic region as well as narrowing of the subglottic airway

Lateral Neck Radiograph

Foreign Bodies on Lateral Neck Radiographs in Adults: Imaging Findings and Common Pitfalls

RadioGraphics 2017; 37:323–345

Sagittal anatomic diagram of neck.

N = nasopharynx (skull base to C1)

O = oropharynx (C2–C3)

H = hypopharynx (C3–C5)

L = larynx (C3–C6)

E = cervical esophagus (C6–D1)

T = trachea (C6–D4)

Foreign Bodies on Lateral Neck Radiographs in Adults: Imaging Findings and Common Pitfalls

RadioGraphics 2017; 37:323–345

Adenoidal hypertrophy (children)

The lateral neck x-ray is the main imaging study. The size of the adenoids is less of a consideration than the degree to which they encroach on the nasopharyngeal airway:

Radiopedia

Adenoidal and palatine tonsil enlargement

There is thickening of posterior naso-pharyngeal soft tissue which is indenting naso-pharyngeal air column on posterior aspect. Soft tissue shadow of soft palate and epiglottis is normal. Palatine tonsil shadow is enlarged at inferior aspect of soft palate. Tracheal air column is normal. Cervical spine and pre-vertebral soft tissue shadow appear normal.

Normal: AP

Normal: Lateral

Normal location of the epiglottis on lateral plain film of the neck.

   

  

Croup

Steeple Sign

Although imaging findings are not required for the diagnosis, classic findings of narrowing of the subglottic airway and dilatation of the hypopharynx are supportive of the diagnosis.

Radiopaedia

  

Hypopharynx Dilatation

Imaging Acute Airway Obstruction in Infants and Children.pdf
Foreign Bodies on Lateral Neck Radiographs in Adults.pdf