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Necrotizing fasciitis: an urgent diagnosis

Silvia Paz Maya1, Delfina Dualde Beltrán, Pierre Lemercier

  • 1Hospital Clínico Universitario de Valencia, Avenida del Puerto 204, puerta 9, PC 46023, Valencia, Spain, sipama@hotmail.com.

Skeletal Radiology
|January 29, 2014
PubMed

Insights

Necrotizing fasciitis (NF) is a severe soft-tissue infection. Early diagnosis using imaging, particularly MRI, is crucial for effective treatment and surgical planning.

Area of Science:

  • Infectious Diseases
  • Radiology
  • Surgical Pathology

Background:

  • Necrotizing fasciitis (NF) is a rare, life-threatening soft-tissue infection with increasing incidence.
  • It presents as rapidly spreading necrosis of deep fascia and subcutaneous tissue.
  • Early diagnosis is challenging due to non-specific initial clinical findings.

Purpose of the Study:

  • To highlight the importance of early recognition of necrotizing fasciitis.
  • To review the utility of various diagnostic adjuncts, including imaging.
  • To emphasize the role of imaging in diagnosis, extent assessment, and surgical planning.

Main Methods:

  • Review of literature on necrotizing fasciitis diagnosis.
  • Discussion of laboratory findings and bedside tests (e.g., finger test, biopsy).
  • Emphasis on the role and findings of imaging modalities, especially MRI.

Main Results:

  • Imaging is valuable for confirming NF diagnosis and assessing disease extent.
  • The presence of fascial gas is characteristic but not always present.
  • Deep fascial thickening due to fluid and hyperemia is a key MRI finding.

Conclusions:

  • Early recognition of necrotizing fasciitis is critical due to its rapid progression.
  • Imaging, particularly MRI, plays a vital role in diagnosis and management.
  • MRI can reveal characteristic signs like fascial thickening, aiding surgical planning.

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