To Drain or not to Drain? Point-of-care Ultrasound to Investigate an Axillary Mass: Case Report

Introduction:  Point-of-care ultrasound (POCUS) has great sensitivity in the diagnosis of abscesses and swollen lymph nodes. Many studies outline the characteristics that distinguish abscesses from lymph nodes on POCUS.

Case report:  We present a case from the emergency department in which a patient presented with a potential abscess but was found to have a malignant lymph node on imaging.

Conclusion:  Point-of-care ultrasound can be used to differentiate an abscess from a swollen lymph node. Abscesses are generally anechoic or hypoechoic with septae, sediment or gas contents, and they lack internal vascularity. Benign lymph nodes are echogenic with hypoechoic cortex with hilar vascularity.