Diagnostics
When looking for the cause of a lymph node swelling in the neck, the doctor usually first asks how long the swelling has already lasted, as well as other symptoms and previous illnesses. During the physical examination, the skin near the lymph nodes is usually inspected first, because skin infections and diseases are frequent causes of lymph node swelling. In addition, palpation can provide information about the cause.
The size of the lymph nodes, their ability to move within the skin, their attachment to other lymph nodes and their painfulness under pressure indicate whether they are more likely to be swollen due to an infection, a tumor or for other reasons. In most cases, the palpation is followed by an examination of the mouth and throat area and, if necessary, the thyroid gland. In many cases, a blood test is performed to confirm or exclude the suspicion of an infectious disease such as mononucleosis, rubella, toxoplasmosis or tuberculosis.
If the cause of a long-lasting or otherwise noticeable swelling of the lymph nodes is unclear, or if other symptoms such as weight loss, night sweats or lymph node swelling in other parts of the body appear, further diagnostic means must be used to find the cause. These may include an X-ray of the lungs and abdomen, ultrasound examinations and computer tomography. In some cases, individual lymph nodes may need to be removed in order to determine the exact cause of the disease and the next steps.
Lymph node swelling in the neck is often located exactly at the lower edge of the skull bone at the back of the head. The medical term for lymph nodes at the back of the head is occipital lymph nodes. The swollen lymph node is usually palpated at the affected area with a small “knob”.
This is usually movable against the skin, and palpation can be both painful and painless. Often a swollen lymph node does not occur on its own, so that further lymph node swelling can be found in the neck or other places (behind the ears, on the side of the neck, etc. ).