Necrotizing fasciitis and its mimics: What radiologists need to know

Ammar Chaudhry, Kevin S. Baker, Elaine S. Gould, Rajarsi Gupta

Research output: Contribution to journalReview article

Abstract

Objective. The purpose of this article is to review the imaging features of necrotizing fasciitis and its potential mimics. Key imaging features are emphasized to enable accurate and efficient interpretation of variables that are essential in appropriate management. Conclusion. Necrotizing fasciitis is a medical emergency with potential lethal outcome. Dissecting gas along fascial planes in the absence of penetrating trauma (including iatrogenic) is essentially pathognomonic. However, the lack of soft-tissue emphysema does not exclude the diagnosis. Mimics of necrotizing fasciitis include nonnecrotizing fasciitis (eosinophilic, paraneoplastic, inflammatory (lupus myofascitis, Churg-Strauss, nodular, or proliferative), myositis, neoplasm, myonecrosis, inflammatory myopathy, and compartment syndrome. Necrotizing fasciitis is a clinical diagnosis, and imaging can reveal nonspecific or negative findings (particularly during the early course of disease). One should be familiar with salient clinical and imaging findings of necrotizing fasciitis to facilitate a more rapid and accurate diagnosis and be aware that its diagnosis necessitates immediate discussion with the referring physician.

Original languageEnglish (US)
Pages (from-to)128-139
Number of pages12
JournalAmerican Journal of Roentgenology
Volume204
Issue number1
DOIs
Publication statusPublished - Jan 1 2015
Externally publishedYes

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Keywords

  • Churg-Strauss fasciitis
  • Eosinophilic fasciitis
  • Lupus myofascitis
  • Necrotizing fasciitis
  • Nodular fasciitis
  • Paraneoplastic fasciitis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

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