Abstract
Ultrasonography is routinely used for the evaluation of skin and soft tissue complaints. It is relatively easy to perform due to the superficial location of each structure allowing for high-frequency imaging, thereby producing high-resolution, detailed images. Commonly, ultrasound is used to evaluate for abscess, cellulitis, and foreign bodies within the skin and soft tissue. Recently, evidence demonstrates that ultrasound is becoming more useful and efficient in the diagnosis of necrotizing fasciitis, a life-threatening condition that requires timely recognition. This chapter will review basic skin and soft tissue anatomy, image acquisition, normal ultrasound anatomy, and interpretation of pathology.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
SonoSim Ultrasound Training Solution [Video]. Santa Monica, CA: SonoSim Inc.; 2017.
Dewitz A. Chapter 18: Musculoskeletal, soft tissue, and miscellaneous applications. In: Ma OJ, Mateer JR, Reardon RF, Joing SA, editors. Emergency ultrasound. 3rd ed. New York: McGraw-Hill Education; 2014. p. 503–68.
Yen Z, Wang H, Ma H, Chen S, Chen W. Ultrasonographic screening of clinically-suspected necrotizing fasciitis. Acad Emerg Med 2002; 9(12):1448–1451. http://onlinelibrary.wiley.com/doi/10.1197/aemj.9.12.1448/epdf. Accessed 17 Apr 2017.
Wronski M, Slodkowski M, Cebulski W, Karkocha D, Krasnodebski I. Necrotizing fasciitis: early sonographic diagnosis. J Clin Ultrasound 2011; 39(4)236–239. http://edus.ucsf.edu/sites/edus.ucsf.edu/files/wysiwyg/Necrotizing%20fasciitis%3A%20Early%20sonographic%20diagnosis.pdf. Accessed 17 Apr 2017.
Jacobson JA. Chapter 6: Hip and thigh ultrasound. In: Jacobson JA, editor. Fundamentals of musculoskeletal ultrasound. 2nd ed. Philadelphia, PA: Sanders; 2013. p. 162–211.
Author information
Authors and Affiliations
Corresponding author
Electronic Supplementary Material
Normal skin and soft tissue ultrasound. Soft tissue layers from superficial to deep include: epidermis, dermis, subcutaneous tissue (hypodermis), fascia, muscle, bone (MP4 629 kb)
Cellulitis. Cellulitis typically appears as cobblestoning of the subcutaneous tissue with associated thickening of the dermal layers (MP4 2251 kb)
Cellulitis with increased tissue edema. Note cobblestoning with increased anechoic areas due to severe cellulitis and/or concomitant tissue edema of other etiology (MP4 2160 kb)
Abscess. Hypoechoic fluid collection with internal echogenic debris representing an abscess (MP4 2040 kb)
Abscess with internal swirling from compression. With compression by the transducer, internal swirling of abscess contents will occur. This can help distinguish an abscess from other etiologies such as a lymph node (MP4 2024 kb)
Necrotizing fasciitis with perifascial fluid. Fluid tracking along the fascial plane with thickened subcutaneous tissue and a loss of normal architecture. Perifascial fluid greater than 4 mm likely indicates a diagnosis of necrotizing fasciitis (MP4 2279 kb)
Hematoma. Hypoechoic fluid collection representing abdominal hematoma. On ultrasound, may be indistinguishable from abscess (MP4 473 kb)
Metal foreign body in long axis. Brightly echogenic foreign body represents a broken needle within the neck of a patient from intravenous drug abuse (MP4 1940 kb)
Metal foreign body in short axis. Brightly echogenic foreign body represents a broken needle within the neck of a patient from intravenous drug abuse (MP4 2110 kb)
Lymph node. Lymph node with hyperechoic medulla surrounded by hypoechoic cortex. Also imaged are two vascular structures that are more round and anechoic when compared with a lymph node (MP4 2174 kb)
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Creditt, A.B., Joyce, M., Tozer, J. (2018). Skin and Soft Tissue Ultrasound. In: Clinical Ultrasound. Springer, Cham. https://doi.org/10.1007/978-3-319-68634-9_15
Download citation
DOI: https://doi.org/10.1007/978-3-319-68634-9_15
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-68633-2
Online ISBN: 978-3-319-68634-9
eBook Packages: MedicineMedicine (R0)