Reliability of Neck Mass Point-of-Care Ultrasound by Pediatric Emergency Physicians

J Ultrasound Med. 2019 Nov;38(11):2893-2900. doi: 10.1002/jum.14993. Epub 2019 Apr 1.


Objectives: Neck masses are a common reason for presentations to the pediatric emergency department (PED). We sought to determine the agreement and time difference between point-of-care ultrasound (POCUS) imaging by pediatric emergency physicians compared to radiology department imaging for children with neck masses in the PED.

Methods: We performed a retrospective study of patients aged 0 to 18 years presenting to our tertiary PED who received both POCUS by a pediatric emergency physician and radiology department imaging. Charts were reviewed for POCUS diagnoses, final diagnoses, and imaging time metrics.

Results: Seventy-five patients met the study criteria. In 58 of 75 cases there was agreement between the POCUS diagnosis and final diagnosis (κ = 0.71; 95% confidence interval, 0.6-0.83). There was agreement in 25 of the 28 cases in which POCUS examinations were performed by PED physicians with fellowship training in POCUS (κ = 0.87; 95% confidence interval, 0.72-1.00). The results for POCUS were generated in a median of 115 minutes (interquartile range, 68-185 minutes) before radiology department imaging results.

Conclusions: Point-of-care ultrasound imaging by pediatric emergency physicians for children with neck masses is a promising new POCUS application that may be able to save time in the PED.

Keywords: neck mass; pediatric emergency medicine; point-of-care ultrasound.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cohort Studies
  • Emergency Service, Hospital*
  • Female
  • Head and Neck Neoplasms / diagnostic imaging*
  • Humans
  • Infant
  • Lymph Nodes / diagnostic imaging
  • Lymphadenopathy / diagnostic imaging*
  • Male
  • Neck / diagnostic imaging
  • Pediatrics
  • Physicians
  • Point-of-Care Systems*
  • Reproducibility of Results
  • Retrospective Studies
  • Salivary Gland Diseases / diagnostic imaging*
  • Salivary Glands / diagnostic imaging
  • Ultrasonography / methods*