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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