Bedside nasopharyngoscopy for direct visualization
Imaging only required if diagnosis uncertain
Lateral neck x-ray
Obliteration of vallecula
Edema of prevertebral and retropharyngeal soft tissues
"Thumb sign" (enlarged epiglottis)
Obliteration of vallecula
Edema of prevertebral and retropharyngeal soft tissues
"Thumb sign" (enlarged epiglottis)
Epiglottitis
Streptococcal pharyngitis 
Peritonsillar cellulitis
Neisseria gonorrhoeae
Nasal foreign body
Diphtheria 
Nasal polyp
Bacterial Tracheitis