March 07, 2024

Ultrasound of Parotitis

6 minutes

In this radiology lecture, we review the ultrasound appearance of parotitis in the pediatric population!

Key teaching points include:

Parotitis = Inflammation of the parotid glands

Acute parotitis is usually infectious, most commonly viral

Mumps is most common viral cause in children, often bilateral

Bacterial parotitis can cause suppurative parotitis seen in premature infants and immunosuppressed children

Acute parotitis on US: Enlarged, heterogeneous, hyperemic gland(s) +/- lymphadenopathy

Since can be bilateral, comparison scanning essential

Bacterial parotitis may be complicated by abscess

“Pomegranate sign” may be seen in setting of acute parotitis: Uniform anechoic foci scattered throughout the gland

Juvenile recurrent parotitis (JRP) = Recurrent inflammatory parotitis in children of unknown etiology

JRP is rare, but second most common cause of parotitis in childhood after mumps

JRP often begins between age 3-6, typically resolves spontaneously after puberty

Usually idiopathic, JRP can be presenting symptom of Sjogren’s syndrome, lymphoma, and underlying immunodeficiency

JRP on US: May be unilateral or bilateral, multiple hypoechoic foci of salivary secretions scattered throughout the gland +/- central calcifications, color Doppler can be normal

Additional causes of parotitis: Sialolithiasis/obstruction, autoimmune (Sjogren syndrome, chronic sclerosing sialadenitis), infectious (HIV, TB), and sarcoidosis (rare in children).

To learn more about the Samsung RS85 Prestige ultrasound system, please visit: https://www.bostonimaging.com/rs85-prestige-ultrasound-system-4

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By Daniel J. Kowal, MD

4.9

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