Ultrasound of lymph nodes for children: in what cases to undergo, what shows, the cost of the procedure

Ultrasound of lymph nodes in a child

Diagnostics in pediatric practice takes on slightly different forms than in conventional therapy. The pediatrician does not have the opportunity to interview the patient in detail for obvious reasons: children cannot describe their complaints or indicate the place that causes anxiety with sufficient clarity, especially for very young children.

Of course, the main descriptive part comes from the words of the child's parents. It is these circumstances that determine the breadth of use of objective, functional diagnostic methods, including ultrasound techniques.

Features of treatment

Most often, inflammation of the lymph nodes in children is a symptom accompanying the underlying disease, so the infection that caused its appearance needs to be treated.
When the underlying disease is cured, lymphadenitis in most cases goes away on its own. The doctor prescribes therapy for the nodes if recovery does not occur. The main methods are UHF therapy, taking medications (including antibiotics), and surgery.

Antibiotics and other medications

Drug therapy is carried out for at least 14 days:

• The doctor prescribes antibiotics of the tetracycline group, such as Ceftriaxone, Amoxiclav, Oracillin, Ampicillin, Flemoxin and Amoxicillin. These drugs are sold with a prescription. They have proven themselves to be effective remedies for lymphadenitis.
• Auxiliary medications are prescribed depending on the patient’s condition; they are designed to enhance the effect of taking the main drug. These may be means to improve immunity, for example, Interferon, Eleutherococcus, Arbidol, tincture of ginseng or echinacea, Immunal, Amiksin and Viferon. They are perfectly complemented by vitamin complexes with a high content of vitamin C.
• To reduce the risk of allergies, Tavegil, Cetrin, Diazolin, Suprastin or Cetirizine are used.
• Sometimes the patient is prescribed antifungal drugs - Ketoconazole, Clotrimazole or Diflucan.

UHF therapy

Ultrahigh frequency therapy is a physiotherapeutic treatment method. Operating principle: the patient’s body is exposed to a high-frequency magnetic field with a wavelength from 1 to 10 meters. The procedure produces a thermal effect, the vessels dilate and leukocytes begin to actively migrate to the enlarged lymph nodes. The local anti-infective immunity of tissues is strengthened, and inflammation goes away much faster.

UHF therapy is prescribed for the acute form of the disease during the period of weakening of accompanying symptoms. Contraindications: specific tuberculous lymphadenitis, fever, muscle pain, rapid heartbeat, suspicion of cancer. It is not recommended to use the method in the presence of benign tumors or hyperthyroidism.

Surgical intervention

This type of treatment is resorted to in cases where medications and physiotherapy have not helped, and purulent complications have begun - an abscess or adenophlegmon.

The operation is performed under anesthesia - the purulent focus is opened, the degree of damage to the tissues surrounding the lymph node is determined, their destroyed parts and accumulated pus are removed. Then the affected area is washed with an antiseptic and sutured.

A special tube (drainage) is inserted into the resulting cavity. Through it there is an outflow of residual pus. If necessary, an antiseptic solution is subsequently injected into it.

Folk remedies

In cases where the lymph nodes are swollen due to a bacterial infection, such as a cold or flu, the use of traditional medicine (compresses and decoctions) as a treatment is quite effective. Remember that self-medication at home can be harmful, so be sure to consult your doctor first. Some recipes:

1. Buy dried echinacea and peppermint at the pharmacy. Boil 1.5 cups of water, add 4 tbsp. spoons of echinacea and continue to boil for 20 minutes. Remove from heat, add a quarter cup of mint to the broth and let steep for 5 minutes. Strain and add honey to taste. For children under 3 years old, give ¼ tsp. 3 times a day, older children – 1 tsp.
2. To prepare a herbal compress, take 1 tsp. chopped nuts, mistletoe, St. John's wort and yarrow, pour a glass of cold water over them and place on the stove. When the broth boils, reduce the heat and simmer for 5 minutes, then let cool. The compress should be done before bedtime. The duration of therapy is up to 3 weeks.
3. For gargling, take 1 tbsp. l. dried chamomile flowers, add to a small saucepan with 200 ml of hot water, place on low heat and bring to a boil. Let the resulting broth cool and brew. On the first day, rinsing should be done every hour, from the second day - every 3 hours.

In what cases is it recommended to undergo an ultrasound of the lymph nodes?

The use of the method of objective examination of lymph nodes is due to its informativeness and non-invasiveness. During the examination, no punctures or painful procedures are performed, so for children undergoing the procedure does not cause any difficulties.

It is advisable to prescribe an ultrasound examination if an enlargement of a group or individual node is suspected. The closer the formations are located to the surface of the body, the simpler and easier it will be to obtain an accurate result. This is especially true for the axillary, inguinal, submandibular, and cervical nodes of the body’s lymphatic system.

As for more deeply located formations, ultrasound will require additional preparation.

Lymph nodes in children

In a healthy child, by the end of the first year of life, some groups of peripheral organs of the vascular system may be palpable. Usually these are inguinal, axillary, submandibular and cervical. The normal size of lymph nodes in children is 1-10 mm. Of course, it is necessary to take into account the age of the child, for example, in newborns the volume of peripheral organs should be within 1-3 mm.

As the child grows older, the number of palpable nodes increases. During a physical examination, the pediatrician pays special attention to the size and structure of the lymph nodes. Normally, they should not exceed the size of a pea and have a soft consistency. When palpated, the lymphatic organs should be mobile (move slightly to the side) and in no case should they hurt when palpated.

When examining a child, the pediatrician takes into account the topography of the enlarged organs, and the diagnosis depends on this. As a rule, in childhood, enlargement of the cervical nodes is associated with ENT diseases of infectious etiology, toxoplasmosis or lymphadenitis.

Indications and possible limitations

The list of indications for ultrasound examination of lymph nodes is quite wide:

• significant increase in one or more groups of nodes;
• soreness of lymphatic formations upon palpation;
• significant compaction of consistency;
• discharge of purulent contents at the site of the node;
• general deterioration in the baby’s well-being in combination with enlarged lymph nodes;
• suspicion of visceral lymphadenopathy;
• tumor pathologies;
• exclusion of other diagnoses – differential diagnosis.

An increase in the size of lymphatic formations in a child, visible to the naked eye, is a fairly serious reason to consult a doctor. The cause of such phenomena can be infectious pathologies, the spread of microorganisms through the bloodstream throughout the body, and their sedimentation in different groups of lymph nodes.

Pain on palpation indicates the presence of a pathological process inside the node itself, which is an unfavorable diagnostic sign. This is the result of the penetration of pathogens deep into the lymphatic drainage system, which should protect the body from various types of aggression. If a microorganism settles in a node, causing a purulent process, it’s time to sound the alarm and deeply examine the baby.

Possible limitations that arise when prescribing an ultrasound examination are significantly narrowed. This may be the lack of equipment with the necessary technical capabilities or a specialist of the appropriate level. This also includes the physical problem of delivering a child to the procedure due to objective reasons: disability, distance.

Treatment of lymph nodes at home

Inflammation of the lymph nodes in the neck is a secondary form of the disease, so treatment should be aimed at eliminating the root cause of the pathology. And you can get rid of lymphadenitis only by removing the infection and increasing immunity.

As therapeutic measures, it is possible to use both traditional therapy and folk methods.

Traditional medicine

Ultrahigh-frequency therapy has been widely used to treat pathology. This is a technique that affects the body using an ultra-strong frequency electromagnetic field.

Anti-inflammatory drugs can only be taken as prescribed by your doctor, as they have many side effects and contraindications. These drugs include: Deltasone, Medron, Prednisol.

Catarrhal and hyperplastic forms of inflammation imply the use of conservative treatment on an outpatient basis.

Key recommendations at these stages:

1. Rest the affected area.
2. Take broad-spectrum antibiotics – 1-3 generation cephalosporins; anti-inflammatory – Diclofenac, Nimesulide; multivitamins – Vitrum, Duovit; absorbable agents – Serta.
3. Use local compresses with Dimexide in the ratio: 1 part of the drug to 4 parts of water.

In the purulent stage of inflammation, the node is opened, the surface of the wound is treated with an antiseptic solution and drained. Subsequent treatment is the same as for a purulent wound. Systemic antibiotics may be prescribed to eliminate intoxication.

Folk remedies

It is important to remember that the use of traditional methods can either help in treatment and speed up the healing process, or cause harm. Various infusions and decoctions are not able to completely get rid of the disease, but can significantly alleviate the condition

Various infusions and decoctions are not able to completely get rid of the disease, but they can significantly alleviate the condition.

There are proven recipes that have repeatedly proven their effectiveness:

1. Echinacea tincture. It is a good antiseptic and the most effective remedy. 10 drops must be diluted with 50 milliliters of boiled water. Take 4 times during the day.
2. Aloe juice. Take one tablespoon of freshly squeezed juice orally daily.
3. Chamomile, mint, calendula. A decoction is prepared from these herbs and is intended for gargling. Procedures must be carried out at least four times a day. In addition, tea can be brewed from the collection.
4. Dried Canadian goldenseal. To take, one spoon of powder is diluted in a glass of water. It is recommended to drink the drink every day. At the same time, fermented milk products should be present in the diet, since such a drink can provoke an upset stomach.
5. Salt and soda. Dilute half a teaspoon of both components in 200 milliliters of hot water. After cooling the solution, gargle several times throughout the day.
6. Green jadeite. The stone should be the size of an inflamed lymph node. It is applied to the affected area for 10 minutes. This is done several times a day.
7. Massage with the addition of essential oils: eucalyptus, lavender and tea tree. Take one part of each and dissolve in olive oil (20 parts). Perform movements carefully, from top to bottom along the neck.

What is forbidden to do if the lymph nodes in the neck are enlarged?

Self-treatment of cervical lymphadenitis using traditional medicine without consulting a specialist can lead to very sad consequences. Lymph nodes are not to be trifled with. If a lump appears and pain occurs when you touch this area, it is strictly forbidden to expose this area to heat. Heating leads to the growth and rapid spread of infectious pathogens; through the bloodstream they enter neighboring organs, not excluding the brain.

In addition, heat exposure can provoke metastasis of malignant neoplasms, and enlarged lymph nodes sometimes indicate the growth of cancer cells in them.

If treatment of the acute form is not started in time, the inflammation can become chronic, accompanied by generalization, scarring of lymphoid tissue and its replacement with connective elements that are not able to perform protective functions.

Here you will learn about the treatment of tracheitis with folk remedies.

Causes of enlarged lymph nodes in a child

The purpose of the entire lymphatic system of the body is a barrier from external infectious agents and not only from them. Lymph nodes are very sensitive barrier structures in children, which are the first to respond to the penetration of dangerous viruses, bacteria, and foreign protein formations into the body.

The main reasons for the increase in the size of nodes compared to normal are:

• infections;
• tumor processes;
• metabolic diseases.

Infections of any origin immediately encounter lymphocytes. They transmit an alarm signal to develop an adequate immune response to the entire body system. The nodes of the group closest to the place where the alien agent was introduced are the first to react. If there is not a local, but a massive enlargement of the lymph nodes, this is a sign of generalization of the infectious process, possibly viral hepatitis, HIV infection.

Tumor cells are the same antigens, so the lymphatic system also reacts to them. In these cases, not only regional, but internal groups of lymph nodes increase: intrathoracic, retroperitoneal, pelvic.

Metabolic pathologies, or they are also called “storage diseases,” are not very common. These include genetically inherited pathologies of metabolic processes in cells. The result of the pathological process is the accumulation of copper or iron metabolic products.

Enlarged lymph nodes in different parts of the body in a child

• Inflammation of the lymph nodes in the back of the head appears if the scalp is affected. In this case, a purulent rash appears, a large number of boils appear, osteomyelitis of the skull, and fungus are observed. Often the occipital and other lymph nodes become inflamed with rubella.
• The parotid lymph nodes become inflamed during the inflammatory process in the outer and middle ear, also with lice, pyoderma, and furunculosis. Lymph nodes near the ears are also often accompanied by atopic dermatitis, eczema, and allergic rashes.
• The lymph nodes of the posterior cervical muscles or lower jaw are enlarged with sore throat, infectious mononucleosis, as well as with chronic tonsillitis and tuberculosis.
• Lymph nodes in the middle of the neck can become inflamed with scarlet fever or tonsillitis. If a child has diphtheria of the tonsils, the lymph nodes become very large. They begin to hurt, become elastic, the surrounding tissues may swell greatly, and then the neck increases in size. If the sore throat is severe, lymphadenitis begins to develop. This group of lymph nodes can become inflamed with Kawasaki syndrome, toxoplasmosis, blood cancer, and also with damage to the lymphatic system.
• The lymph nodes in the side of the neck become inflamed due to an infectious disease of the nasopharynx.
• Lymph nodes in the chin area can become enlarged due to stomatitis and caries.
• The axillary lymph nodes in a child become inflamed with infectious diseases of the hands, shoulder joints - with chicken pox, purulent skin lesions. Lymph nodes can become inflamed after vaccination, and also if the cat scratches.
• Inflamed lymph nodes of the elbow are characteristic of infection of the hand and forearm.

Preparation for ultrasound of lymph nodes in children

No additional preparation is required for this type of diagnosis. The procedure takes place without penetration into the internal environment of the body; it does not require sterile conditions. All you need is a patient, equipment with the appropriate technical characteristics and a specialist trained and qualified in the field of ultrasound diagnostics.

The infant undergoes the examination with the technical assistance of the mother or another adult. Older children need a preliminary psychological conversation in order to overcome possible fears and conduct the examination as comfortably and accurately as possible.

If the retroperitoneal lymph nodes are to be examined, then a few days before the scheduled ultrasound, it is necessary to exclude from the child’s diet foods that can cause increased gas formation in the intestines: rye bread, apples, cucumbers, cabbage. This will help to carry out the procedure with maximum diagnostic results.

What home treatment methods are there?

In parallel with drug and therapeutic treatment of lymphadenitis, the doctor will definitely recommend several procedures and discuss the rules for caring for a sick child at home.

Home care rules include:

1. For any disease, if the lymph node behind the ear of a child is enlarged, heating this area is prohibited, since heat can activate the purulent process in the lymphatic system.
2. Limiting walks in wet and cold weather, taking care of your ears and head.
3. Taking multivitamins to help restore the child’s immunity.
4. Reduce stress, rest and rest.

Strict implementation of all recommendations, adherence to the regimen and taking prescribed medications will allow you to quickly cure your baby and maintain his health.

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Carrying out ultrasound of lymph nodes in children depending on their location

The technical complexity of examining a group of lymph nodes depends on its location. Therefore, parental assistance is necessary when examining very young children in order to ensure maximum access to the inflammatory locus.

Ultrasound of the lymph nodes of the neck

A doctor can perform an ultrasound of the lymph nodes in a child’s neck without an assistant. The baby is placed on the couch, or you can do this in an upright position for an older child. A gel must be applied to the surface of the skin, which improves the transmission of ultrasonic waves and increases the efficiency of the study. Read more about this study.

Ultrasound of submandibular lymph nodes

For this type, it is necessary to position the patient to ensure maximum access to the group of submandibular lymphatic formations. You can ask to change the position of the head and chin so that the picture becomes absolutely clear.

Ultrasound of axillary lymph nodes

The most accessible group of lymph nodes is located in the armpits. For the examination, the patient must be placed on the couch and asked to place his hands behind his head. In this position, the chest expands and breathing becomes as amplitude as possible. Enlarged lymph nodes are clearly visible on the screen of an ultrasound device, and you can get a clear picture of the ongoing process.

Ultrasound examination of the groin area

For younger and middle children, the groin area remains a very sensitive marker of internal pathological processes. Therefore, an increase in the size of the inguinal group is a rather alarming sign. Children usually tolerate the procedure well because it is also painless.

About cervical lymphadenitis

Parents often turn to a well-known pediatrician with complaints about enlarged lymph nodes in their child’s neck. Before answering the question of how to treat this unpleasant disease, Evgeniy Olegovich advises to carefully understand the possible true reasons for the enlargement of nodules. Determining this is not as difficult as it seems. It all depends on the location of the enlarged node:

1. According to the pediatrician, an increase in the so-called retropharyngeal nodes (located at the junction of the lower jaw and the edge of the auricle) is most often caused by pathogenic microbes living in the pharynx.
2. If the lymph nodes under the lower jaw are inflamed, infections of the mouth and face are most likely to blame. If there is no inflammation in the indicated areas, then Komarovsky advises considering the option of infection with atypical mycobacteria.
3. Nodules on the neck (side or back) may indicate the presence of a source of infection in the immediate vicinity (inflammation of the respiratory tract, larynx, skin infections).

enlargement of the occipital nodes a sign of successful functioning of the immune system in the process of the body’s fight against various viral pathogens. If a child has suffered from ARVI, influenza, or adenovirus, then such an increase cannot be considered an independent illness. This increase does not require treatment and usually goes away on its own within 2-3 weeks.

Bilateral inflammation is an alarming symptom that can accompany infectious mononucleosis, toxoplasmosis, secondary syphilis and other serious diseases. If the nodule is inflamed on one side, there is no need to worry. According to Komarovsky, this may indicate that this particular node works as part of the immune system a little more actively than its other counterparts, taking on an additional “load.” Its increase cannot be considered a sign of disease.

The most common causes of cervical lymphadenitis, according to Evgeniy Komarovsky, lie in numerous lymphotropic viral infections, which even include the familiar herpes, adenoviral infection and others.

In any case, the doctor says, parents should not panic and immediately drag their poor child to a variety of medical specialists. In most cases, urgent and urgent treatment is not required, and often the inflamed lymph node returns to normal on its own, without any effort on the part of doctors, mothers, fathers and grandmothers. You should not immediately go to the pharmacy for antibiotics. But you definitely need to visit a pediatrician and get a referral for tests.

Possible errors during research

Since the list of pathologies that cause inflammation and enlarged lymph nodes in children is quite large, errors are also possible. It must be remembered that ultrasound itself is a clarifying method that gives an idea of ​​the nature of changes in the tissues of the lymph node, the extent of the spread of the pathological process, but cannot establish the cause of inflammation.

Therefore, in order to avoid erroneous interpretation of the results of ultrasound examination of the lymph nodes, it is necessary to additionally include in the diagnostic plan:

• blood analysis;
• bacteriological cultures;
• X-ray data;
• other types of studies at the discretion of the doctor.

A comprehensive, complete examination will allow you to take into account the nuances of the disease, make an accurate diagnosis and prescribe adequate treatment.

How to treat a lymph node behind the ear in a child

If inflammation is detected behind the ear, the baby should undergo a full health diagnosis. Often, a blood test is necessary to make an accurate diagnosis.

In addition, the patient should undergo a computed tomography scan and x-ray.

After the examination and the results obtained, the doctor prescribes treatment.

Depending on the case, the patient is prescribed the following medications:

• antibiotics and penicillins, for example, Flemoxin Solutab ;
• in case of enlarged lymph nodes due to allergens, the patient is prescribed antihistamines “Zirtec”, “Telfast”, “Erius” ;
• antimicrobial drugs “Ibuklin”, “Nurofen”, “Paracetamol” ;
• Medicines are also needed to raise the general tone in the body: “Cefotaxime”, “Tsiprolet”, “Cefalexin” .

In case of inflammation due to signs of otitis media, the patient is prescribed specialized drops and antibiotics. In milder cases, for example, otitis externa, only ear drops and physiotherapy, including heat treatment and laser therapy, are sufficient.

To reduce pain, the little patient is prescribed painkillers, treatment with dressings and various tinctures.

For more serious diseases, for example, acute purulent lymphadenitis, surgical intervention cannot be avoided.

Before the operation, the patient is prescribed a special course of antibiotics and preoperative exercises.

What an ultrasound shows: decoding

The result of the examination in the ultrasound diagnostic room is a conclusion that is provided to the attending physician. It is he who, based on the information not received, decides on the treatment of the patient.

The conclusion indicates the size of the examined lymph nodes, their density, homogeneity, the nature of the echogenic structure of the tissues, and the degree of displacement in localization compared to normal values. Also, the diagnostician must indicate the presence of concomitant, nearby pathological changes in tissues: adhesions, compression of nodes by neighboring organs, patency of blood vessels, fullness or lack of blood supply.

Normal indicators

Enlarged lymph nodes are diagnosed when the size indicator exceeds 1 cm. Above these sizes, there are lymphatic structures that respond to an infectious process or other causes of the disease. The exception is the inguinal lymph nodes, which can reach 1.5 cm in size in healthy children. This is due to the high level of blood circulation in the groin area and the presence of intestinal microflora.

It should also be taken into account that healthy nodes have average or normal echogenic density. Their structure is uniform, vascularization - penetration by blood vessels also remains at an average level. Excess of these parameters or their decrease indicate a pathological picture; the child should be examined in the most serious manner.

Cost of pediatric ultrasound

Since the procedure is quite widespread, there is a wide choice of specialists. Therefore, when prescribing examinations using ultrasound techniques by the attending physician, you can choose according to several criteria:

• technical capabilities of the equipment;
• qualification of a diagnostician;
• ultrasound cost.

If the first two points need to be clarified by understanding specialists, then cost is a purely subjective indicator. The price can fluctuate in Moscow alone from 1000 rubles to 1500 rubles for similar procedures. When choosing, of course, it is necessary first of all to think about achieving the final goal of the study - an accurate diagnosis.