<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>Soft tissue and osseous musculoskeletal infections are common but can be difficult to diagnose clinically. Signs, symptoms, and physical examination findings may be nonspecific, and laboratory values can be inconclusive. The extent of disease may also be underestimated on physical examination. Soft tissue infections most commonly occur secondary to direct inoculation from broken skin and less frequently due to the seeding of the soft tissues from hematogenous spread, while osseous infections are more commonly due to hematogenous seeding. Infections may also be iatrogenic, following surgery or other procedural interventions. High-resolution ultrasound is an extremely useful imaging modality in the evaluation of musculoskeletal soft tissue and joint infections, and can occasionally be used to evaluate osseous infections as well. Ultrasound can aid in the early diagnosis of musculoskeletal infections, allowing for prompt treatment, decreased risk of complications, and treatment optimization. Ultrasound is sensitive and specific in evaluating soft tissue edema and hyperemia; soft tissue abscesses; joint, bursal and tendon sheath effusions/synovitis; and subperiosteal abscesses. This article describes the typical high-resolution grayscale as well as color and power Doppler ultrasound imaging findings of soft tissue infections including cellulitis, fasciitis, necrotizing deep soft tissue infection, pyomyositis, soft tissue abscess, infectious bursitis, and infectious tenosynovitis. Ultrasound findings of septic arthritis as well as osteomyelitis, such as subperiosteal spread of infection (subperiosteal abscess). are also reviewed. In addition, the use of ultrasound to guide fluid and tissue sampling is discussed.</p>
</abstract>

Soft tissue and osseous musculoskeletal infections are common but can be difficult to diagnose clinically. Signs, symptoms, and physical examination findings may be nonspecific, and laboratory values can be inconclusive. The extent of disease may also be underestimated on physical examination. Soft tissue infections most commonly occur secondary to direct inoculation from broken skin and less frequently due to the seeding of the soft tissues from hematogenous spread, while osseous infections are more commonly due to hematogenous seeding. Infections may also be iatrogenic, following surgery or other procedural interventions. High-resolution ultrasound is an extremely useful imaging modality in the evaluation of musculoskeletal soft tissue and joint infections, and can occasionally be used to evaluate osseous infections as well. Ultrasound can aid in the early diagnosis of musculoskeletal infections, allowing for prompt treatment, decreased risk of complications, and treatment optimization. Ultrasound is sensitive and specific in evaluating soft tissue edema and hyperemia; soft tissue abscesses; joint, bursal and tendon sheath effusions/synovitis; and subperiosteal abscesses. This article describes the typical high-resolution grayscale as well as color and power Doppler ultrasound imaging findings of soft tissue infections including cellulitis, fasciitis, necrotizing deep soft tissue infection, pyomyositis, soft tissue abscess, infectious bursitis, and infectious tenosynovitis. Ultrasound findings of septic arthritis as well as osteomyelitis, such as subperiosteal spread of infection (subperiosteal abscess). are also reviewed. In addition, the use of ultrasound to guide fluid and tissue sampling is discussed.

High-resolution ultrasound in the evaluation of musculoskeletal infections

Journal of Ultrasonography

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

{"article-title":"High-resolution ultrasound in the evaluation of musculoskeletal infections"}

Soft tissue and osseous musculoskeletal infections are common but can be difficult to diagnose clinically. Signs, symptoms, and physical examination findings...

High-resolution ultrasound in the evaluation of musculoskeletal infections

Article Category: Review Paper

Published Online: Nov 23, 2023

Page range: e272 - e284

Received: Jul 03, 2023

Accepted: Jul 31, 2023

DOI: https://doi.org/10.15557/jou.2023.0034

Keywords
US, cellulitis, fasciitis, abscess, osteomyelitis

© 2023 Jennifer S. Weaver et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

High-resolution ultrasound in the evaluation of musculoskeletal infections

Article Category: Review Paper

Published Online: Nov 23, 2023

Page range: e272 - e284

Received: Jul 03, 2023

Accepted: Jul 31, 2023

DOI: https://doi.org/10.15557/jou.2023.0034

KeywordsUS, cellulitis, fasciitis, abscess, osteomyelitis

© 2023 Jennifer S. Weaver et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Keywords
US, cellulitis, fasciitis, abscess, osteomyelitis