Paeds Cases · ent-hearing-and-oral-health
Explain a persistent neck lump and the safety-net to a parent — OSCE
OSCE communication station: explaining to a parent why their child's neck lump needs an ultrasound, what the four-to-six-week rule and a supraclavicular location mean, what to watch for, and when to return urgently with the red flags for a deep neck abscess or a malignancy.
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You are the paediatric registrar. A 6-year-old boy is referred by his general practitioner with a five-week history of a painless lump in the right side of the neck. It has not changed much in size, he is otherwise well, and there are no red flags on examination, but because it has lasted five weeks you have arranged a neck ultrasound and are reviewing the family. His mother has ten minutes with you and wants to understand: (1) why he is having an ultrasound rather than just a course of antibiotics; (2) what the lump could turn out to be; (3) what to watch for and when to bring him back. Explain with empathy, check understanding, and agree a clear plan. [1]
References3ShowHide
- [1]Weinstock MS, Patel NA, Smith LP. Pediatric Cervical Lymphadenopathy. Pediatr Rev, 2018.PMID 30171054
- [2]Ho ML. Pediatric Neck Masses: Imaging Guidelines and Recommendations. Radiol Clin North Am, 2022.PMID 34836558
- [3]Roy CF, Balakrishnan K, Boudewyns A, et al. International Pediatric Otolaryngology Group: consensus guidelines on the diagnosis and management of non-tuberculous mycobacterial cervicofacial lymphadenitis. Int J Pediatr Otorhinolaryngol, 2023.PMID 36764081