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MRI in necrotizing fasciitis of the extremities.
[pyomyositis]
Necrotizing
fasciitis
is
a
life-threatening
soft
-tissue
infection
of
bacterial
origin
,
which
involves
mainly
the
deep
fascia
.
Early
recognition
of
this
condition
may
be
hampered
by
the
uncommon
nature
of
the
disease
and
non-specificity
of
initial
clinical
signs
and
symptoms
in
less
fulminant
cases
,
making
the
role
of
imaging
important
.
MRI
is
the
most
useful
imaging
modality
in
the
diagnosis
of
necrotizing
fasciitis
.
The
presence
of
thick
(
>
3
 
mm
)
hyperintense
signal
in
the
deep
fascia
(
particularly
intermuscular
fascia
)
on
fat-suppressed
T
2
weighted
or
short
tau
inversion-recovery
images
is
an
important
marker
for
necrotizing
fasciitis
.
Contrast
enhancement
of
the
thickened
necrotic
fascia
can
be
variable
,
with
a
mixed
-pattern
of
enhancement
being
more
commonly
encountered
.
Involvement
of
multiple
musculofascial
compartments
increases
the
likelihood
of
necrotizing
fasciitis
.
It
is
important
to
remember
that
T
2
-
hyperintense
signal
in
the
deep
fascia
is
not
specific
to
necrotizing
fasciitis
and
can
also
be
seen
in
cases
such
as
non-infective
inflammatory
fasciitis
or
muscle
tear
.
In
this
pictorial
essay
,
we
aim
to
review
the
MRI
findings
in
necrotizing
fasciitis
,
discuss
its
limitations
and
pitfalls
and
identify
differentiating
features
from
non-necrotizing
soft
-tissue
infections
,
such
as
cellulitis
and
infective
myositis
/
pyomyositis
,
conditions
which
may
clinically
mimic
necrotizing
fasciitis
.
Diseases
Validation
Diseases presenting
"infective myositis"
symptom
pyomyositis
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