Imaging Pearls ❯ Musculoskeletal ❯ Skin and Soft Tissue
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- CT Imaging of the Skin and Soft Tissues
Clinical applications
- Trauma
- Tumors
- Infection
- Iatrogenic
- Calcification
- Congenital - “A broad spectrum of skin and subcutaneous (SQ) findings may be discovered in the emergency setting on CT examinations. There are some findings that are directly relevant to the reason or reasons why the patient has undergone the CT examination. However, other findings may be incidental. The skin and SQ tissues are by definition on the periphery of CT images and may be overlooked by the radiologist, although findings related to them can be of clinical importance.”
CT of the skin and subcutaneous tissues.
Katz DS1, Ganson G, Klein MA, Mazzie JP.
Emerg Radiol. 2013 Jan;20(1):57-68. - “The skin and SQ tissues are by definition on the periphery of CT images and may be overlooked by the radiologist, although findings related to them can be of clinical importance.”
CT of the skin and subcutaneous tissues.
Katz DS1, Ganson G, Klein MA, Mazzie JP.
Emerg Radiol. 2013 Jan;20(1):57-68. - ”The purpose of this pictorial essay is to present a broad spectrum of skin and subcutaneous findings which may be identified on CT examinations in the emergency setting (and in some cases nonemergently), and to briefly review the relevant imaging literature, which surprisingly is relatively limited on this topic. Categories of cutaneous and subcutaneous abnormalities that will be covered include trauma and hemorrhage, iatrogenic findings, infection, neoplasms, calcification, and other miscellaneous entities, all of which may initially present on emergency CT examinations of the body.’
CT of the skin and subcutaneous tissues.
Katz DS1, Ganson G, Klein MA, Mazzie JP.
Emerg Radiol. 2013 Jan;20(1):57-68. - “Calcifications in the skin and SQ tissues should also be routinely evaluated by the radiologist, when present. For example, dermatomyositis is a connective tissue disease related to polymyositis, which is characterized by inflammation of the muscles and skin. Dystrophic soft tissue and muscle calcifications develop as a result, which are identifiable on CT.”
CT of the skin and subcutaneous tissues.
Katz DS1, Ganson G, Klein MA, Mazzie JP.
Emerg Radiol. 2013 Jan;20(1):57-68. - “In conclusion, a broad spectrum of skin and subcutaneous findings may be discovered on emergency as well as on non-emergency CT examinations. Some of these findings are directly relevant to the reasons why the patients have undergone the CT examinations, whereas others may be incidental. Skin and subcutaneous findings, particularly if not the primary clinical focus of the examinations, are easily overlooked on CT and should, therefore, be routinely evaluated by the interpreting emergency or other radiologist, regardless of the portion(s) of the body imaged.”
CT of the skin and subcutaneous tissues.
Katz DS1, Ganson G, Klein MA, Mazzie JP.
Emerg Radiol. 2013 Jan;20(1):57-68. - “Cutaneous and subcutaneous malignancies represent the most common type of cancer and frequently present with overlapping imaging appearances. CT, MRI, and 18F-FDG PET/CT are commonly used for staging, preoperative planning, and posttreatment assessment. Knowledge of the multimodality imaging features can narrow down the differential diagnosis and elucidate their metastatic pattern.”
Malignant Skin and Subcutaneous Neoplasms in Adults: Multimodality Imaging With CT, MRI, and 18F-FDG PET/CT
Yu-Hsiang Juan et al.
AJR 2014; 202:W422–W438 - “Cutaneous lymphomas can be either primary or secondary to the disseminated disease. T-cell lymphomas are most common (65% of cases), and B-cell lymphomas account for the remainder. Although the reported incidence of cutaneous metastases from internal malignancies is rare (about 0.7–10% of cases), it often indicates underlying widespread metastatic disease and poor prognosis.”
Malignant Skin and Subcutaneous Neoplasms in Adults: Multimodality Imaging With CT, MRI, and 18F-FDG PET/CT
Yu-Hsiang Juan et al.
AJR 2014; 202:W422–W438 - Cutaneous neurofibromas
Cutaneous neurofibromas are also called discrete or dermal neurofibromas. These tumors grow from small nerves in the skin or just under the skin and appear as small bumps typically beginning around the time of puberty. It is less common to see this type of neurofibroma in young children with NF1 - “Anatomically, musculoskeletal infections can be classified into superficial and deep infections. Superficial infections are considered to include infections involving the skin and hypodermis, whereas deep infections involve the soft tissues at and below the level of the fascia. This classification is oversimplified and arbitrary, as infection spreads not only in horizontal planes but also vertically, invading the boundaries between the superficial and deep layers.”
Soft-Tissue Infections and Their Imaging Mimics: From Cellulitis to Necrotizing Fasciitis
Mohammad Reza Hayeri et al.
RadioGraphics 2016; 36:1888–1910 - Cellulitis is a nonnecrotizing infection limited to the subcutaneous tissue, hypodermis, and superficial fascia without muscular or deep fascial in- volvement. Staphylococcus aureus and Streptococcus pyogenes are the most common offending agents gaining access to the skin through a penetrating skin defect. Less commonly, it can be secondary to hematogenous spread or extension from an underlying deep infection in immunocompromised patients.
Soft-Tissue Infections and Their Imaging Mimics: From Cellulitis to Necrotizing Fasciitis
Mohammad Reza Hayeri et al.
RadioGraphics 2016; 36:1888–1910