Condition | Distinguishing clinical features |
Mastoiditis (<2 years) | Ear pain (may manifest as irritability) |
Postauricular tenderness, erythema, swelling (obliterating postauricular crease), fluctuance, or mass (poorly circumscribed, immobile) |
Displacement of the auricle (downward and outward) |
Abnormal tympanic membrane |
Mastoiditis (>2 years) | Ear pain |
Postauricular tenderness, erythema, swelling (obliterating postauricular crease), fluctuance, or mass (poorly circumscribed, immobile) |
Displacement of the auricle (upward and outward) |
Abnormal tympanic membrane |
Postauricular lymphadenopathy | Well-circumscribed and freely mobile mass |
Periauricular cellulitis without otitis externa | Normal tympanic membrane |
Periauricular cellulitis with otitis externa | Severe pain over the tragus and pinna |
Auricular perichondritis | Preservation of the postauricular crease |
Normal tympanic membrane |
Mumps | Swelling over the parotid gland rather than the mastoid |
Normal tympanic membrane |
Mastoid tumor | Normal tympanic membrane |