Soft Tissue X Ray of Neck

A soft tissue x ray of neck is a diagnostic imaging technique that is helpful in the diagnosis of a variety of disorders. These images are characterized by low exposure to allow better examination of the neck’s soft tissues. The images in a soft tissue neck series consist of an anterior-posterior (AP) and lateral (B) x ray. An example of such an x-ray is shown in Figure 4-2. A physician should examine these images carefully because abnormalities may be indicative of pathology. In particular, an abnormality in the retropharyngeal spaces could be indicative of epiglottitis, croup, or a retropharyngeal abscess.


A soft tissue x-ray of the neck can identify a wide variety of problems. For example, it can reveal abnormalities in the air that fills the soft tissues, including compression and deviation of air-filled structures. It can also detect radiopaque foreign bodies. A CT also has the benefit of being able to distinguish between specific tissue densities. The findings of a neck CT are best assessed using a systematic approach.

One of the most common reasons for performing a CT of the neck is the presence of a foreign body. This may be a tumor or a mass. It may also be a foreign object that has been swallowed and lodged in the esophagus or upper airway. Patients should discuss the results with their physician to get a clearer understanding of what may be causing their symptoms.


An AP soft tissue x ray of the neck is a diagnostic tool used to visualize the neck and airway. The x-ray is useful for a variety of diagnoses, including epiglottitis, croup, retropharyngeal abscess, airway foreign bodies, and glottis abnormalities.

In a patient with suspected neck pathology, a AP soft tissue x-ray is a better way to evaluate the neck’s soft tissues. The x-ray shows how these soft tissues compare to the surrounding structures. Bone, for example, is often referred to as a “metal density” and has a higher density than air, fat, and water. The x-ray also helps differentiate adjacent structures by highlighting their differences in density.


A lateral soft tissue x-ray of the neck can be an important diagnostic tool. This type of imaging helps to identify foreign bodies that have lodged in the neck. Foreign bodies in the neck can range in size and density from air to fat and from water to fluids. The radiograph of the neck can also reveal airway foreign bodies.

This lateral soft tissue x-ray of the neck is a useful adjunct to upper airway symptoms diagnosis. Despite its usefulness, the lateral soft tissue neck radiograph is often inadequately reviewed. In this article, we review its typical findings and the robust systems that are currently available to improve analysis.

Otitis externa

A soft tissue x-ray of the neck can reveal evidence of otitis externa. The disease progresses over time and patients may develop multiple symptoms. The most common clinical features include severe otalgia, ear discharge, and one or more cranial nerve palsies. Other characteristic clinical findings included osteolysis of the clivus on CT or MRI and one or more biopsies of inflamed areas. Three of these biopsies were taken from mastoid cells, while the others were obtained through trans-nasal approaches.

Most cases of otitis externa can be diagnosed and treated as an outpatient. Mild cases are treated with topical agents that last for five to ten days. Moderate and severe cases may require surgery. Treatment may include surgical removal of inflamed soft tissue or insertion of a wick. Patients may undergo repeat visits for ototopical agents if the current treatment fails to relieve their symptoms. Patients may also need to undergo inpatient admission if the soft tissue appears to be expanding or if they suspect that they have a deep plane infection or MOE.

Retropharyngeal abscess

A 74-year-old male presents with a complaint of difficulty swallowing, fever, and neck pain. A lateral X-ray reveals an abscess with a broadened soft tissue shadow in the retropharyngeal space. An axial CT scan reveals a cystic lesion abutting the vertebral bodies and effacing the pharyngeal airway. The X-rays also reveal jet black air densities.

A retropharyngeal abscess is usually first discovered in young children and often develops as a result of an upper respiratory tract infection. If not detected early, the abscess can progress to suppuration and perforation and lead to upper airway obstruction. In the most severe cases, the abscess can lead to asphyxia due to the obstruction of the airway.

Guidelines for interpretation

Soft-tissue x-rays of the neck can be helpful in diagnosing various conditions. They can be used to rule out retropharyngeal abscesses and diagnose epiglottitis. They are also useful for identifying airway foreign bodies. In addition, they can be helpful in detecting croup.

Neck CT should be performed using intravenous contrast material to maximize its sensitivity for detecting vascular and bony complications and abscesses. However, it is not necessary to use contrast material in the presence of suspected retained aerodigestive tract foreign bodies because it may obscure small foreign bodies. Hence, many institutions choose not to administer intravenous contrast material in these situations.

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