Back to Skin and Soft Tissue Infection 4

Skin and Soft Tissue Infection (SSTI) - MR

Case Images

View Images / Launch Visage

Case Notes

History

Nonhealing ulcer. Evaluate for osteomyelitis.

Exam

Prior Study

Dicom

 

Findings

You scored: 0 / 21
Limitations Correct Answer Your Answer

There is patient motion or other limitations.

 No  NA
Skin/Hypodermis Correct Answer Your Answer

There is edema or hyperenhancement.

 Yes  NA

There is soft tissue ulceration or sinus tract.

Yes  NA

There is gas or foreign body.

 No  NA

There is confluent hypoenhancement to suggest phlegmon, suppuration, abscess, or drainable fluid collection in the hypodermis.

 No  NA
Investing/Intermuscular Fascia Correct Answer Your Answer

There is edema, thickening, or hyperenhancement.

Yes  NA

There is hypoenhancement or gas/susceptibility artifact.

 No  NA

There is bulging of the fascia.

 No  NA
Muscles Correct Answer Your Answer

There is edema or hyperenhancement.

Yes  NA

There is hypoenhancement, lack of enhancement, or organized fluid collection.

No  NA

There is fatty atrophy.

 No  NA
Bones Correct Answer Your Answer

There are fractures.

 No  NA

There is periosteal reaction, osseous destruction, or other abnormal marrow to suggest osteomyelitis.

 No  NA

There is osseous hypoenhancement or lack of enhancement to suggest loss of bone viability.

 No  NA

There is cloaca, sequestrum, or involucrum.

 No  NA

There is a subperiosteal or intra-osseous abscess.

 No  NA
Visualized Joints Correct Answer Your Answer

There is a joint effusion or synovitis.

 No  NA

There is malalignment, degenerative changes, or other gross internal derangement.

 No  NA
Miscellaneous Correct Answer Your Answer

There is tenosynovitis.

 No  NA

Major visualized vascular structures are abnormal.

 No  NA

Major visualized nerves are abnormal.

 No  NA

Impression

Expert Answer

Soft tissue wound along the posterolateral aspect of the distal calf and ankle. Underlying cellulitis, myositis, and fasciitis may all be reactive. No definitive MR evidence to suggest necrotizing soft tissue infection though this remains a clinical diagnosis.

Your Answer

Recommendations & Acuity

Recommendations

Expert Answer

Follow up as clinically indicated.

Your Answer

Acuity

Expert Answer

Urgent (Action Necessary in a few hours)

Your Answer

View Reference Material
Section 1

Submit Findings

CB1129

Findings

Limitations

There is patient motion or other limitations.

Skin/Hypodermis

There is edema or hyperenhancement.

There is soft tissue ulceration or sinus tract.

There is gas or foreign body.

There is confluent hypoenhancement to suggest phlegmon, suppuration, abscess, or drainable fluid collection in the hypodermis.

Investing/Intermuscular Fascia

There is edema, thickening, or hyperenhancement.

There is hypoenhancement or gas/susceptibility artifact.

There is bulging of the fascia.

Muscles

There is edema or hyperenhancement.

There is hypoenhancement, lack of enhancement, or organized fluid collection.

There is fatty atrophy.

Bones

There are fractures.

There is periosteal reaction, osseous destruction, or other abnormal marrow to suggest osteomyelitis.

There is osseous hypoenhancement or lack of enhancement to suggest loss of bone viability.

There is cloaca, sequestrum, or involucrum.

There is a subperiosteal or intra-osseous abscess.

Visualized Joints

There is a joint effusion or synovitis.

There is malalignment, degenerative changes, or other gross internal derangement.

Miscellaneous

There is tenosynovitis.

Major visualized vascular structures are abnormal.

Major visualized nerves are abnormal.