Necrotizing fasciitis of the lower extremity: imaging pearls and pitfalls

Br J Radiol. 2018 Jul;91(1088):20180093. doi: 10.1259/bjr.20180093. Epub 2018 Mar 28.

Abstract

Objective: The purpose of this article is to review the imaging findings of necrotizing fasciitis as seen on radiograph, ultrasound, CT, and MRI, and to recognize the early findings in this potentially fatal disease.

Conclusion: Although classically a clinical diagnosis, imaging is a powerful adjunct to facilitate early diagnosis in equivocal cases. Compared to plain radiography, ultrasound, CT and MR provide higher sensitivity and specificity for the diagnosis of necrotizing fasciitis. Cross-sectional imaging findings include asymmetric thickening of fascia, soft tissue air, blurring of fascial planes, inflammatory fat stranding, reactive lymphadenopathy, and nonenhancement of muscular fascia.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Fasciitis, Necrotizing / diagnostic imaging*
  • Humans
  • Lower Extremity*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Radiography
  • Tomography, X-Ray Computed
  • Ultrasonography