AP (image 1) and lateral (image 2) radiographs of the forear | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

AP (image 1) and lateral (image 2) radiographs of the forearm in a child with new-onset wrist pain shows small locules of air (arrow) within the deep soft tissues. Necrotizing fasciitis is typically not an entity that can be diagnosed by imaging. Radiograph typically shows only soft tissue swelling. Locules of deep soft tissue gas are uncommonly present. The locules of air in this patient represent small foci of gas formed by anaerobic bacteria. #MSKMonday #MusculoskeletalMonday

More about this case

UnresolvedResolvedRareTrending

Why you should join Figure 1

Similar cases

Sagittal image from a contrast-enhanced head CT shows a prefrontal soft tissue mass (yellow arrow), opacification of the frontal sinus (red arrow), and a small locule of air deep to frontal bone at the soft tissue mass. The findings are typical of Potts Puffy Tumor. Potts puffy tumor is a complication of acute sinusitis with a subperiosteal subcutaneous abscess and osteomyelitis. The frontal sinus is the most common originating site of infection. #NeuroWednesday



Air-fluid level and cluster of soft tissue gas on #X-ray. Ultrasound shows large 13 x 2 x 8 cm abscess.](https://app.figure1.com/case-detail/33550442-1869-421d-8063-2b308e0d8761)



Image description
Lateral radiograph of the airway (image 1) shows widening of the retropharyngeal soft tissues with narrowing of the upper airway. Soft tissue stranding is present in the submandibular space. Axial contrast-enhanced CT (images 2 and 3) shows a retropharyngeal fluid collection (arrow) with faint rim enhancement (arrowhead).

Teaching point
On lateral neck radiographs, abnormal widening of the retropharyngeal soft tissues and airway narrowing raise concern for deep neck space infection. CT can help to distinguish an abscess from phlegmon. Key distinguishing features include air within a collection or nearby soft tissues or a low-attenuation collection with peripheral enhancement.



AP (image 1) and oblique (image 2) radiograph of the great toe shows a destructive lesion (arrow) affecting the distal phalanx. Sagittal T2 (image 3) and T1 (image 4) as well as coronal (image 5) T2 MRI shows a soft tissue mass (arrow) affecting the distal phalanx of the great toe. At resection this mass was confirmed to represent an EWSR1-SMAD3–positive fibroblastic tumour. This tumor is a recently characterized neoplasm that typically presents as a small painless tumor affecting the extremity subcutaneous tissues. They have a benign behavior although are prone to local recurrences.

Trending now



A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.
He had a history of hypertension, long-term smoking, and a sedentary lifestyle.
On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.



A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets.
Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.



A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.



patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?