What should you know?
Lymph nodes commonly enlarge in response to infection or inflammation and then regress. Persistent growth, unusual firmness or associated systemic symptoms should be assessed.
Ultrasound evaluates shape and internal architecture, not size alone. Fatty hilum, cortical thickness, necrosis and vascular pattern help the radiologist decide whether a node looks reactive or needs further work-up.
Common symptoms and signs
- A palpable neck, armpit or groin node
- Tenderness during an acute infection
- Persistent fever, night sweats or unexplained weight loss
- A painless hard or enlarging node
Diagnosis and the role of ultrasound
Targeted ultrasound measures both axes and evaluates shape, hilum, cortex, necrosis and Doppler flow. It can also guide needle sampling when indicated.
- Oval versus round shape
- Preserved fatty hilum
- Cortical thickness and symmetry
- Distribution of blood flow
Treatment and next steps
Treatment addresses the cause: a reactive node may need observation, infection may require specific therapy and a suspicious node may require biopsy. Antibiotics should not be started without an indication.
When is urgent care needed?
- Difficulty breathing or swallowing
- Rapid enlargement with redness and high fever
- Nodes with marked weakness, night sweats or weight loss