ANAMNESIS / SYMPTOMS:
A 89 year old patient reports about pain and a trismus with emphasis on the right side. The intake of food is impossible since a couple of days.


FINDINGS:
Caudal of the hypoechoic, altogether in its echogenity irregularly changed parotid gland shows an area with highly echoic reflections and a hypoechoic halo that has an extent of some cm. An evaluation of the structures located distal from the finding is hardly possible because of the signal extinction. The only definable structure is the mandible with its distal acoustic shadow.


DIAGNOSIS:
On the basis of the raised symptoms and of the sonographic findings the patient is suspected of having an extensive abscess formation with air inclusions in the retromandibular region that is spreading towards the oropharynx.