- For children with suspected peritonsillar abscess (PTA), the use of transcervical ultrasound was associated with emergency department (ED) visits that were >1 hour shorter vs use of CT.
- Authors suggest ultrasound-first diagnostic standard for these patients.
Why this matters
- Clinical diagnosis of PTA has relatively low sensitivity and low specificity.
- CT is highly sensitive but irradiating.
- Intraoral ultrasound may not easily be tolerated, and it can be difficult to clean the transducer.
- Transcervical and intraoral ultrasound perform similarly to CT for PTA diagnosis.
- Patients receiving ultrasound (n=286) vs CT (n=101):
- Mean length of stay (LOS) in ED, in minutes: 347±145 vs 426±171; absolute difference, 79 (95% CI, 44-113).
- Difference significant only among patients with negative study result.
- Return visits within 2 weeks: 8.0% vs 5.9% (P=.66).
- No patients who received ultrasound required subsequent CT.
- Retrospective cohort study at freestanding pediatric hospital (n=387).
- Authors compared ED LOS before vs after hospital adopted transcervical ultrasound-first protocol for suspected PTA (2009-2013 vs 2013-2017).
- Funding: None disclosed.
- Nonrandomized single-center before-after study.
- Radiologists, not emergency physicians, performed ultrasound.