Axial (image 1) and sagittal (image 2 and 3) contrast-enhanc | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

Axial (image 1) and sagittal (image 2 and 3) contrast-enhanced CT and a patient with new-onset of a firm nonmobile forehead mass show soft tissue swelling over the frontal bone with a rim-enhancing fluid collection (arrow, images 1 and 2) deep to the bone at this level. A small component of the collection extends into the anterior soft tissues (arrowhead). There is an erosion of the bone adjacent to the subcutaneous collection (arrow, image 3). The findings are consistent with a Pott's puffy tumor. Pott's puffy tumor is a subperiosteal abscess associated with osteomyelitis occurring as a complication of frontal sinusitis. #NeuroWednesday

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Sagittal image from a contrast-enhanced head CT shows a prefrontal soft tissue mass (yellow arrow), opacification of the frontal sinus (red arrow), and a small locule of air deep to frontal bone at the soft tissue mass. The findings are typical of Potts Puffy Tumor. Potts puffy tumor is a complication of acute sinusitis with a subperiosteal subcutaneous abscess and osteomyelitis. The frontal sinus is the most common originating site of infection. #NeuroWednesday](https://app.figure1.com/case-detail/2f6511b2-b39b-434f-8f1b-7424c8811da8)


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Image description
Lateral radiograph of the airway (image 1) shows widening of the retropharyngeal soft tissues with narrowing of the upper airway. Soft tissue stranding is present in the submandibular space. Axial contrast-enhanced CT (images 2 and 3) shows a retropharyngeal fluid collection (arrow) with faint rim enhancement (arrowhead).
Teaching point
On lateral neck radiographs, abnormal widening of the retropharyngeal soft tissues and airway narrowing raise concern for deep neck space infection. CT can help to distinguish an abscess from phlegmon. Key distinguishing features include air within a collection or nearby soft tissues or a low-attenuation collection with peripheral enhancement.](https://app.figure1.com/case-detail/446560f7-31f9-4bcc-ba38-5a80c249dd9d)