Swollen Glands That Will Not Go Down: When a Lymph Node Ultrasound Is Used

Swollen glands are lymph nodes doing their job. The NHS says they are usually caused by common illnesses such as colds, tonsillitis and ear or throat infections, sometimes by viral infections such as glandular fever, and only rarely by something more serious. Swollen glands caused by an infection, the NHS says, usually get better by themselves within 1 to 2 weeks.

The UK Health Security Agency reported on 8 October that early signs suggest flu season may be starting earlier than usual, so plenty of people will be feeling a tender lump under the jaw this autumn. This guide is about what to do when the lump outlasts the illness.

What the NHS says should send you to a GP

The NHS swollen glands page lists the reasons to see a GP: the glands are getting bigger or have not gone down within 1 week; they feel hard or do not move when you press them; you are having night sweats or a very high temperature; you have no other signs of illness or infection; or the swollen glands are just above or below your collarbone. The NHS lumps page adds that a swelling in the neck, armpit or groin that does not go down within 2 weeks should be checked.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you have swollen glands and are finding it very difficult to swallow or have difficulty breathing. Those are not scan questions; they need same-day assessment.

The GP visit matters because much of the diagnosis happens in the room. The NHS lumps page says the GP will look at the lump, may be able to tell you what is causing it, and if unsure might refer you to hospital for tests such as an ultrasound scan or a biopsy.

When an ultrasound of the lymph node is the right test

Ultrasound is a common first scan for a lump in the neck, armpit or groin because it shows the size, shape and internal structure of a node in real time, uses no radiation, and can guide a needle sample in the same visit. For some symptom patterns, NICE's suspected cancer guideline (NG12) says GPs should consider a suspected cancer pathway referral, for example for adults with unexplained swollen lymph nodes (taking into account symptoms such as fever, night sweats, breathlessness, itching or weight loss), or for people aged 45 and over with an unexplained lump in the neck. In that case the ultrasound happens within the hospital pathway.

An ultrasound is not usually the right test on day 5 of a cold. It becomes the right test when the NHS criteria above are met and a clinician has examined you: a node that persists beyond the illness, keeps growing, feels hard or fixed, sits above the collarbone, or comes with night sweats or no obvious infection. See what ultrasound can detect.

What happens at the scan

The scan is quick and painless. The James Paget University Hospitals NHS Foundation Trust neck ultrasound leaflet says an ultrasound scan requires little to no preparation, beyond leaving jewellery at home and tying back long hair, and a Sherwood Forest Hospitals leaflet explains that the ultrasound itself may provide all the information needed.

If the operator sees something that needs more information, they may suggest a fine needle aspiration (FNA) or core biopsy there and then. Sherwood Forest describes FNA as a small sample taken with a thin needle guided by ultrasound, with a local anaesthetic, taking about 15 minutes, with a small risk of bleeding or bruising, and with fewer than 1 in 20 samples needing to be repeated. James Paget says a biopsy appointment takes roughly 20 to 30 minutes in total.

Results follow two timetables. Sherwood Forest says the ultrasound report is normally available within a day or so, while the laboratory analysis of a needle sample takes at least a few days; James Paget says results are usually available a week later. The NHS non-Hodgkin lymphoma diagnosis page makes the hierarchy clear: a biopsy is the main test, and scans are used afterwards to see how far anything has spread. See how long scan results take.

Children, glandular fever and lumps that are not glands

Children and teenagers get swollen glands with almost every infection. The NHS glandular fever page says the illness is most common in people aged 15 to 24, that most people start to feel better within 2 to 4 weeks, and advises seeing a GP for a very high temperature, a severe sore throat, swelling either side of the neck or extreme tiredness. For children, any scan should be arranged through the GP or paediatric team rather than by parents directly.

Lumps that are not lymph nodes are common too. The NHS lumps page lists possibilities such as a cyst, a lipoma, a hernia in the groin and a goitre at the front of the neck, and a GP can often tell them apart by examination.

Having a private lymph node ultrasound

If your GP has examined you and suggested an ultrasound of a neck, armpit or groin lump, and the NHS wait is longer than you would like, a private scan is an option. Many clinics accept self-referral for ultrasound, but ask whether the clinic can take a needle sample if needed, and make sure the report goes to your GP. If your GP has made a suspected cancer pathway referral, the NHS pathway is the right route and a private scan should not replace it.

You can compare ultrasound clinics near you on FindScan and send an enquiry; the clinic contacts you to confirm whether it needs a referral and the next steps. FindScan is a directory of independent, regulated imaging clinics: you compare clinics and send an enquiry, and the clinic contacts you. We are not a healthcare provider, and nothing here replaces a GP examination. If you have swollen glands and difficulty swallowing or breathing, ask for an urgent GP appointment or contact NHS 111 today, and call 999 if someone is struggling to breathe.