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Pharyngitis — Imaging Recommendations — Clinical Pathway: Emergency Department and Inpatient

Suspected Pharyngitis or Peritonsillar Abscess (PTA) Clinical Pathway — Emergency Department and Inpatient

Imaging Recommendations

CT Neck w/ IV Contrast
  • Gold standard for diagnosis of PTA
    • Contrast-enhanced, IV only, no PO
    • Scan time < 1 min
US Soft Tissue Neck
(incl Doppler)
  • A single-center study has shown transcervical neck US has sensitivity (75-80%) and specificity (88-92.8%) in diagnosing PTA and has been shown to result in decreased CT utilization and decreased ED LOS
  • Transcervical neck US has been shown to have an NPV of 100% with no difference in clinical outcomes and no failures of medical management in those with negative ultrasounds
  • May require CT for confirmation

References

 

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