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Necrotizing Fasciitis
B.J. Manaster, MD, PhD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Necrotizing fasciitis (NF): Aggressive, rapidly progressive soft tissue infection that tracks along both superficial (early) and deep fascial planes causing necrosis by microvascular occlusion
              • Fournier gangrene: Necrotizing fasciitis of perineum

            IMAGING

            • General Features

              • Radiograph and CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  • Reporting Tips

                                    Selected References

                                    1. Paz Maya S et al: Necrotizing fasciitis: an urgent diagnosis. Skeletal Radiol. 43(5):577-89, 2014
                                    2. Kim KT et al: Can necrotizing infectious fasciitis be differentiated from nonnecrotizing infectious fasciitis with MR imaging? Radiology. 259(3):816-24, 2011
                                    3. Edlich RF et al: Modern concepts of the diagnosis and treatment of necrotizing fasciitis. J Emerg Med. 39(2):261-5, 2010
                                    4. Turecki MB et al: Imaging of musculoskeletal soft tissue infections. Skeletal Radiol. 39(10):957-71, 2010
                                    5. Seok JH et al: Necrotizing fasciitis versus pyomyositis: discrimination with using MR imaging. Korean J Radiol. 10(2):121-8, 2009
                                    6. Yu JS et al: MR imaging of urgent inflammatory and infectious conditions affecting the soft tissues of the musculoskeletal system. Emerg Radiol. 16(4):267-76, 2009
                                    7. Levenson RB et al: Fournier gangrene: role of imaging. Radiographics. 28(2):519-28, 2008
                                    8. Fayad LM et al: Musculoskeletal infection: role of CT in the emergency department. Radiographics. 27(6):1723-36, 2007
                                    9. Fugitt JB et al: Necrotizing fasciitis. Radiographics. 24(5):1472-6, 2004
                                    10. Jallali N: Necrotising fasciitis: its aetiology, diagnosis and management. J Wound Care. 12(8):297-300, 2003
                                    11. Arslan A et al: Necrotizing fasciitis: unreliable MRI findings in the preoperative diagnosis. Eur J Radiol. 36(3):139-43, 2000
                                    12. Brothers TE et al: Magnetic resonance imaging differentiates between necrotizing and non-necrotizing fasciitis of the lower extremity. J Am Coll Surg. 187(4):416-21, 1998
                                    13. Schmid MR et al: Differentiation of necrotizing fasciitis and cellulitis using MR imaging. AJR Am J Roentgenol. 170(3):615-20, 1998
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Pathology

                                            • Diagnostic Checklist

                                              TERMINOLOGY

                                              • Definitions

                                                • Necrotizing fasciitis (NF): Aggressive, rapidly progressive soft tissue infection that tracks along both superficial (early) and deep fascial planes causing necrosis by microvascular occlusion
                                                • Fournier gangrene: Necrotizing fasciitis of perineum

                                              IMAGING

                                              • General Features

                                                • Radiograph and CT Findings

                                                  • MR Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Demographics

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  DIAGNOSTIC CHECKLIST

                                                                  • Consider

                                                                    • Reporting Tips

                                                                      Selected References

                                                                      1. Paz Maya S et al: Necrotizing fasciitis: an urgent diagnosis. Skeletal Radiol. 43(5):577-89, 2014
                                                                      2. Kim KT et al: Can necrotizing infectious fasciitis be differentiated from nonnecrotizing infectious fasciitis with MR imaging? Radiology. 259(3):816-24, 2011
                                                                      3. Edlich RF et al: Modern concepts of the diagnosis and treatment of necrotizing fasciitis. J Emerg Med. 39(2):261-5, 2010
                                                                      4. Turecki MB et al: Imaging of musculoskeletal soft tissue infections. Skeletal Radiol. 39(10):957-71, 2010
                                                                      5. Seok JH et al: Necrotizing fasciitis versus pyomyositis: discrimination with using MR imaging. Korean J Radiol. 10(2):121-8, 2009
                                                                      6. Yu JS et al: MR imaging of urgent inflammatory and infectious conditions affecting the soft tissues of the musculoskeletal system. Emerg Radiol. 16(4):267-76, 2009
                                                                      7. Levenson RB et al: Fournier gangrene: role of imaging. Radiographics. 28(2):519-28, 2008
                                                                      8. Fayad LM et al: Musculoskeletal infection: role of CT in the emergency department. Radiographics. 27(6):1723-36, 2007
                                                                      9. Fugitt JB et al: Necrotizing fasciitis. Radiographics. 24(5):1472-6, 2004
                                                                      10. Jallali N: Necrotising fasciitis: its aetiology, diagnosis and management. J Wound Care. 12(8):297-300, 2003
                                                                      11. Arslan A et al: Necrotizing fasciitis: unreliable MRI findings in the preoperative diagnosis. Eur J Radiol. 36(3):139-43, 2000
                                                                      12. Brothers TE et al: Magnetic resonance imaging differentiates between necrotizing and non-necrotizing fasciitis of the lower extremity. J Am Coll Surg. 187(4):416-21, 1998
                                                                      13. Schmid MR et al: Differentiation of necrotizing fasciitis and cellulitis using MR imaging. AJR Am J Roentgenol. 170(3):615-20, 1998