To become familiar with the clinical scenario,
pathophysiology and most frequently involved sites in necrotizing fasciitis.
To review the indications of different imaging modalities and their role in the diagnosis.
To recognize the typical imaging findings in each modality available in the emergency department: Plain radiography,
Ultrasound and Computed Tomography.
Soft-tissue infections are frequent in clinical practice,
among which stand a less frequent subtype,
the necrotizing soft tissue infections.
These affect superficial,
deep tissues and adjacent fascias,
and are characterized by rapid progression,
tissue destruction and signs of systemic toxicity.
Early recognition remains one of the most important prognostic factors; nevertheless,
this disease is frequently misdiagnosed in initial stages as clinical manifestation is not usually straightforward,
therefore imaging plays an important role in achieving a prompt diagnosis.
The most superficial structures of the soft-tissues...
Findings and procedure details
Although the utility of imaging is limited in NF,
currently it is accepted its role with the following objectives:
Confirm the diagnosis in clinically doubtful cases.
Anatomic information useful for the surgery.
Depicting the extent of tissue involvement.
in patients who are severely compromised or with high clinical suspicion,
surgical treatment should not be delayed for the performance of imaging.
In our hospital center over the last two years studied,
we have observed that all the cases diagnosed of NF underwent imaging...
Necrotizing fasciitis is an aggressive disease whose diagnosis is difficult to establish clinically.
The most important predictor of mortality is a delay in diagnosis.
Imaging procedures play an important role in the assessment of necrotizing fasciitis,
especially in clinically doubtful cases and for depicting the extent of tissue involvement.
The radiologist must be familiar with the imaging findings of each technique.
1 Hayeri MR,
Soft-tissue infections and their imaging mimics: from cellulitis to necrotizing fasciitis.
Radiographics 2016; 36: 1888–910.
2 Chaudhry AA,
Necrotizing fasciitis and its mimics: what radiologists need to know.
AJR Am J Roentgenol 2015; 204: 128–39
3 Tso DK,
Necrotizing fasciitis of the lower extremity: imaging pearls and pitfalls.
Br J Radiol 2018; 91: 20180093
Inflammatory and infections in the soft tissues.