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Case of the Week 519



What is the most likely diagnosis?

  • 38 year-old with extreme pain in left leg



Axial CT scan through both legs

  1. Lipohemarthrosis
  2. Osteomyelitis
  3. Testicular Torsion
  4. Paget Disease
  5. Necrotizing Fasciitis

Additional Images-Axial CT scan through both legs

 

Additional Images

 



Axial CT scan through both legs


Answer:

 

5. Necrotizing Fasciitis

 

More (Click Discussion Tab)

 

 

Necrotizing Fasciitis

General Considerations

  • A rapidly progressive, infection of fascia which leads to subsequent necrosis of the subcutaneous tissue; muscles are frequently spared
  • It may be caused by several organisms of groups of organisms
    • Type 1: Polymicrobial
      • Bacteroides, Clostridium, or Peptostreptococcus) in combination with streptococci other than group A and E. coli, Enterobacter, Klebsiella or Proteus
    • Type 2: Group A beta-hemolytic streptococcus
    • Clostridial infections (gas gangrene)

    MORE . . .

     


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    is an award-winning educational website aimed primarily at medical students and radiology residents-in-training, containing  lectures, handouts, images, Cases of the Week, archives of cases, quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, GU cardiac, bone and neuroradiology.