Imaging of Soft Tissue Infections

Salastekar, Ninad; Su, Andres; Rowe, Jean; Somasundaram, Aravind; Wong, Phillip; Hanna, Tarek N.

doi:10.1016/j.rcl.2022.08.003

Cited by 8 publications

(9 citation statements)

References 63 publications

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“…8) refers to infection of the epidermis, dermis, hypodermis, and occasionally the superficial fascia, often with broken skin and skin ulceration (1,2,(25)(26)(27) . Usually occurring due to direct inoculation, Staphylococcus aureus and Streptococcus pyogenes are the most common causative organisms (2,9,28,29) . Clinically, patients present with soft tissue swelling, pain, and erythema.…”

Section: Cellulitismentioning

confidence: 99%

“…2, Fig. 3) is an infected organized focal fluid collection of debris and inflammatory cells surrounded by hyperemic connective tissue (1,2,27,29) . These may result from direct inoculation, contiguous spread from an adjacent infection, or hematogenous spread (1,3,30) .…”

Section: Phlegmon/abscessmentioning

confidence: 99%

“…Patients with underlying muscle injury are at an increased risk of developing pyomyositis (20,28,31,32) . Underlying systemic illnesses, such as human immunodeficiency virus infection, diabetes mellitus, malnutrition, hematologic malignancy, and organ transplantation, also increase the risk of pyomyositis (18,28,29,33) . Although any skeletal muscle may be involved, the quadriceps, gluteal, and iliopsoas musculature are most commonly affected (20,27,28,32,33) .…”

Section: Myositismentioning

confidence: 99%

“…Color and power Doppler interrogation shows hypervascularity in the affected region. Thin, linear fluid deposits are frequently present along interlobular septa and along hyperechoic fat lobules, creating a "cobblestone" appearance (1,9,(27)(28)(29)(54)(55)(56) . US is helpful to evaluate for associated deep venous thrombosis or superficial thrombophlebitis (Fig.…”

Section: Cellulitismentioning

confidence: 99%

“…If gas is present within the abscess or the adjacent soft tissues, it will appear as small echogenic foci with ring down artifact consistent with reverberation artifact (Fig. 4 C-E) (29,56,57) . Swirling purulent material may be noted with application of transducer pressure to the abscess (9,56) .…”

Section: Abscess/phlegmonmentioning

confidence: 99%

See 4 more Smart Citations

High-resolution ultrasound in the evaluation of musculoskeletal infections

Weaver,

Omar,

Epstein

et al. 2023

J Ultrason

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Soft tissue and osseous musculoskeletal infections are common but can be difficult to diagnose clinically. Signs, symptoms, and physical examination findings may be nonspecific, and laboratory values can be in- conclusive. The extent of disease may also be underestimated on physical examination. Soft tissue infections most commonly occur secondary to direct inoculation from broken skin and less frequently due to the seed- ing of the soft tissues from hematogenous spread, while osseous infections are more commonly due to he- matogenous seeding. Infections may also be iatrogenic, following surgery or other procedural interventions. High-resolution ultrasound is an extremely useful imaging modality in the evaluation of musculoskeletal soft tissue and joint infections, and can occasionally be used to evaluate osseous infections as well. Ultrasound can aid in the early diagnosis of musculoskeletal infections, allowing for prompt treatment, decreased risk of complications, and treatment optimization. Ultrasound is sensitive and specific in evaluating soft tissue edema and hyperemia; soft tissue abscesses; joint, bursal and tendon sheath effusions/synovitis; and subperi- osteal abscesses. This article describes the typical high-resolution grayscale as well as color and power Dop- pler ultrasound imaging findings of soft tissue infections including cellulitis, fasciitis, necrotizing deep soft tissue infection, pyomyositis, soft tissue abscess, infectious bursitis, and infectious tenosynovitis. Ultrasound findings of septic arthritis as well as osteomyelitis, such as subperiosteal spread of infection (subperiosteal abscess). are also reviewed. In addition, the use of ultrasound to guide fluid and tissue sampling is discussed.

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Section: Cellulitismentioning

confidence: 99%

Section: Phlegmon/abscessmentioning

confidence: 99%

Section: Myositismentioning

confidence: 99%

Section: Cellulitismentioning

confidence: 99%

Section: Abscess/phlegmonmentioning

confidence: 99%

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High-resolution ultrasound in the evaluation of musculoskeletal infections

Weaver,

Omar,

Epstein

et al. 2023

J Ultrason

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Point‐of‐care ultrasound in skin and soft tissue infections

Koppa,

Kelly

2024

Journal of Hospital Medicine

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BackgroundSkin and soft tissue infections (SSTIs) are commonly encountered in clinical practice. Point‐of‐care ultrasound (POCUS) is becoming an increasingly valuable tool in hospital medicine, especially with advancements in ultrasound technology that make it easier to perform. POCUS can augment the history and physical exam in patients with suspected SSTIs. POCUS can detect deeper infections, such as abscesses, and expedite time to surgical debridement for life‐threatening infections such as necrotizing fasciitis (NF).ObjectivesThis review provides an introduction on how to perform and interpret a skin and soft tissue POCUS exam, the key sonographic findings for SSTIs, and how to incorporate these findings into clinical reasoning and management.MethodsSSTI POCUS literature was reviewed using PubMed. All relevant studies with a defined protocol and reported sensitivity and specificity pertaining to the use of POCUS to diagnose SSTIs in adults were included. The authors provide additional input based on their ultrasound expertise and clinical experience.ResultsA total of seven studies met the criteria to be included in this review.ConclusionsSoft tissue POCUS is a valuable tool for hospitalists to improve diagnostic accuracy and patient care when assessing suspected SSTIs. Access to equipment, POCUS training, and experience are barriers to widespread use. However, performing a soft tissue POCUS exam is straightforward. It requires less training compared to other POCUS exams, and it has notable potential for routine future practice in the evaluation and management of suspected SSTIs and other dermatologic conditions.

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Imaging of MSK infections in the ER

Kompel,

Guermazi

2023

Skeletal Radiol

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Imaging of Soft Tissue Infections

Cited by 8 publications

References 63 publications

High-resolution ultrasound in the evaluation of musculoskeletal infections

High-resolution ultrasound in the evaluation of musculoskeletal infections

Point‐of‐care ultrasound in skin and soft tissue infections

Imaging of MSK infections in the ER

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