Postauricular swelling with tenderness typically indicates what condition?

Postauricular swelling accompanied by tenderness typically indicates mastoiditis. This condition is characterized by inflammation and infection of the mastoid air cells situated in the mastoid bone located just behind the ear. When an ear infection, particularly acute otitis media, is left untreated or is severe, it can spread to the mastoid process, leading to mastoiditis.

Key signs of mastoiditis include not only the postauricular swelling and tenderness but also fever, redness, and possible displacement of the auricle (the external part of the ear) forward and downward. This clinical presentation is distinct from other conditions. Swimmer's ear, or otitis externa, primarily affects the external auditory canal and does not typically cause swelling behind the ear. An ear infection usually presents with inner ear symptoms and might not necessarily lead to postauricular tenderness. Similarly, cerumen impaction can cause discomfort and hearing impairment but does not cause swelling or tenderness at the postauricular area.

Thus, when postauricular swelling and tenderness are present, it is important to consider mastoiditis as a serious complication requiring prompt medical attention.