Instead, the differential diagnosis under consideration should drive the imaging decision, based on expected features of the pathology and the capabilities of each modality. Given the range of potential pathology discussed earlier, it should come as little surprise that no single clinical decision rule can be used to inform decisions for soft-tissue neck imaging. Who Needs Soft-Tissue Imaging? Which Imaging Modality Should Be Used? Imaging of the soft tissues of the cervical spinal cord and ligaments are discussed in Chapter 3. In this chapter, we explore the modalities available for soft-tissue cervical imaging, discuss clinical indications for imaging in a variety of chief complaints, and review some characteristic findings of important pathology, using the figures throughout the chapter. Imaging of the neck often is performed with imaging of the head or chest, as structures passing through the neck extend into these adjacent body regions. Fascial planes connect compartments of the neck with the mediastinum and thoracic prevertebral spaces, posing a risk of spread of infection from the neck to these regions. Remember that referred pain from other regions of the body may present with neck pain, so a broad differential diagnosis should be entertained in formulating an imaging plan. The neck contains vascular, nerve, airway, gastrointestinal, and bony structures, any of which may be the source of pain. Imaging of soft tissues of the neck can be essential in the evaluation of patients with a variety of chief complaints, including neck trauma, ingested or aspirated foreign body, nontraumatic neck pain and swelling, dysphagia and voice change, visible or palpable mass, and central nervous system complaints with possible vascular causes.
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