A Cheeky Diagnosis

HPI: 3 yo female with no PMH presenting for L sided facial pain and swelling x 1 day.

POCUS of affected side showed:

Note the hypoechoic spots within the gland that give it a “moth eaten” appearance. This is a classic finding in parotitis. Note the dilated ducts within which may represent a distal sialolithiasis.

Note nearby lymph nodes above.

Contralateral side for comparison:



Signs of parotitis on POCUS:

  • Enlarged, heterogeneous gland compared to contralateral side

  • Increased vascularity/color flow

  • Duct dilation

  • Increased quantity of surrounding lymph nodes

Case conclusion: The patient was diagnosed with likely viral parotitis. She was well appearing with no fever, overlying cellulitis, or trismus and was discharged with Pediatrician follow up!


Happy Scanning!

  • The US Team

Learn more:

  1. https://www.acep.org/sonoguide/advanced/ent

  2. https://ultrasoundpaedia.com/parotid-gland-normal/