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Likelihood Ratio (LR) in Emergency Medicine

1/08/2012

Soft tissue abscess: clinical plus ultrasound evaluation

Male 65 y/o, he complains pain and swelling in left groin, he has history of hypertension. He has not fever. Clinical examination shows swelling, skin is hot and  eritematous.






Is it an abscess, a cellulitis or something else? 
















Conclusion 


To use ultrasound on eritematous and swelling skin is very helpful 
Abscesses presents as a spherical structure with “pus in movement”.  
Celluliti’s morphology, instead, has a “cooblestoning effect”, with diffuse hyperechogenicity of subcutaneous fat.

Ultrasonography is a useful adjunct to clinical evaluation of soft tissue infection, it increases diagnostic accuracy and guides treatment decision.


Bibliography 

BT Squire, JC Fox, C Anderson
ABSCESS: applied bedside sonography for convenient evaluation of superficial soft tissue infections
Acad Emerg Med July 2005, Vol. 12, No. 7 

DW Struk, PL Munk
Imaging of softs tissue infections
Radiol Clin of N Am vol 39 n2 Mar 2001




Ciro Paolillo


2 comments:

  1. First time visiting your wonderful page! Even if the post is old, I would like to comment. The advantage of using US in management of abscesses is not only to get the diagnosis. Even when doing the incision it's much easier with US. You can measure the depth of the incision and the best point to place the incision. Sometimes you vill be surprised how deep someone has to cut.

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