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Soft Tissue Abscess
A. Carlson Merrow, Jr., MD, FAAP
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Suppurative or purulent: Pus forming/pus containing
              • Abscess: Walled-off, liquefied collection of necrotic tissue, inflammatory cells, & bacteria
              • Phlegmon: Poorly defined focus of necrotic & inflammatory tissue ± components of liquefaction
              • Cellulitis: Poorly defined changes of superficial (i.e., skin & subcutaneous fat) soft tissue infections
              • Fasciitis: Inflammation in & along superficial & deep fascial planes investing muscles
              • Pyomyositis: Deep muscle infection
              • Skin & soft tissue infections (SSTI): Any of above

            IMAGING

            • General Features

              • Radiographic Findings

                • Ultrasonographic Findings

                  • MR Findings

                    • CT Findings

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Altmayer S et al: Imaging musculoskeletal soft tissue infections. Semin Ultrasound CT MR. 41(1):85-98, 2020
                                      2. Arnon-Sheleg E et al: PET/CT imaging in soft tissue infection and inflammation-an update. Semin Nucl Med. 50(1):35-49, 2020
                                      3. Nelson CE et al: Ultrasound features of purulent skin and soft tissue infection without abscess. Emerg Radiol. 25(5):505-11, 2018
                                      4. Chang CD et al: Imaging of musculoskeletal soft tissue infection. Semin Roentgenol. 52(1):55-62, 2017
                                      5. Song KS et al: Key role of magnetic resonance imaging in the diagnosis of infections around the hip and pelvic girdle mimicking septic arthritis of the hip in children. J Pediatr Orthop B. 25(3):234-40, 2016
                                      6. Verma S: Pyomyositis in children. Curr Infect Dis Rep. 18(4):12, 2016
                                      7. Penn EB Jr et al: Pediatric inflammatory adenopathy. Otolaryngol Clin North Am. 48(1):137-51, 2015
                                      8. Pattamapaspong N et al: Pitfalls in imaging of musculoskeletal infections. Semin Musculoskelet Radiol. 18(1):86-100, 2014
                                      9. Soldatos T et al: Magnetic resonance imaging of musculoskeletal infections: systematic diagnostic assessment and key points. Acad Radiol. 19(11):1434-43, 2012
                                      10. Ranson M: Imaging of pediatric musculoskeletal infection. Semin Musculoskelet Radiol. 13(3):277-99, 2009
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Definitions

                                                  • Suppurative or purulent: Pus forming/pus containing
                                                  • Abscess: Walled-off, liquefied collection of necrotic tissue, inflammatory cells, & bacteria
                                                  • Phlegmon: Poorly defined focus of necrotic & inflammatory tissue ± components of liquefaction
                                                  • Cellulitis: Poorly defined changes of superficial (i.e., skin & subcutaneous fat) soft tissue infections
                                                  • Fasciitis: Inflammation in & along superficial & deep fascial planes investing muscles
                                                  • Pyomyositis: Deep muscle infection
                                                  • Skin & soft tissue infections (SSTI): Any of above

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • Ultrasonographic Findings

                                                      • MR Findings

                                                        • CT Findings

                                                          • Nuclear Medicine Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Altmayer S et al: Imaging musculoskeletal soft tissue infections. Semin Ultrasound CT MR. 41(1):85-98, 2020
                                                                          2. Arnon-Sheleg E et al: PET/CT imaging in soft tissue infection and inflammation-an update. Semin Nucl Med. 50(1):35-49, 2020
                                                                          3. Nelson CE et al: Ultrasound features of purulent skin and soft tissue infection without abscess. Emerg Radiol. 25(5):505-11, 2018
                                                                          4. Chang CD et al: Imaging of musculoskeletal soft tissue infection. Semin Roentgenol. 52(1):55-62, 2017
                                                                          5. Song KS et al: Key role of magnetic resonance imaging in the diagnosis of infections around the hip and pelvic girdle mimicking septic arthritis of the hip in children. J Pediatr Orthop B. 25(3):234-40, 2016
                                                                          6. Verma S: Pyomyositis in children. Curr Infect Dis Rep. 18(4):12, 2016
                                                                          7. Penn EB Jr et al: Pediatric inflammatory adenopathy. Otolaryngol Clin North Am. 48(1):137-51, 2015
                                                                          8. Pattamapaspong N et al: Pitfalls in imaging of musculoskeletal infections. Semin Musculoskelet Radiol. 18(1):86-100, 2014
                                                                          9. Soldatos T et al: Magnetic resonance imaging of musculoskeletal infections: systematic diagnostic assessment and key points. Acad Radiol. 19(11):1434-43, 2012
                                                                          10. Ranson M: Imaging of pediatric musculoskeletal infection. Semin Musculoskelet Radiol. 13(3):277-99, 2009