Early diagnosis of necrotizing fasciitis: Imaging techniques and their combined application

Abstract

Necrotizing fasciitis is a clinical, surgical emergency characterized by an insidious onset, rapid progression, and a high mortality rate. The disease's mortality rate has remained high for many years, mainly because of its atypical clinical presentation, which prevents many cases from being diagnosed early and accurately, resulting in patients who may die from uncontrollable septic shock and multi‐organ failure. But unfortunately, no diagnostic indicator can provide a certain early diagnosis of NF, and clinical judgement of NF is still based on the results of various ancillary tests combined with the patient's medical history, clinical manifestations, and the physician's experience. This review provides a brief overview of the epidemiological features of NF and then discusses the most important laboratory indicators and scoring systems currently employed to diagnose NF. Finally, the latest progress of several imaging techniques in the early diagnosis of NF and their combined application with other diagnostic indices are highlighted. We point out promising research directions based on an objective evaluation of the advantages and shortcomings of different methods, which provide a basis for further improving the early diagnosis of NF.

A Comparison of the Application of Two Different Scoring Systems in a Patient With Upper Limb Necrotizing Fasciitis

“…In a retrospective study in the United Arab Emirates (UAE) in 2007 by Hefny et al, it was found that out of 11 patients presenting to the hospital over two years with NF, seven were initially misdiagnosed [ 10 ]. Other studies have also noted that in approximately 85% of cases, NF is not considered as the initial diagnosis (Wei et al, 2023) [ 11 ]. This ambiguity can manifest if clinical judgment alone is used to make a diagnosis.…”