Lower extremity infections: Essential anatomy and multimodality imaging findings

George R Matcuk Jr; Matthew R Skalski; Dakshesh B Patel; Brandon K K Fields; Leah E Waldman; Paolo Spinnato; Ali Gholamrezanezhad; Sanaz Katal

doi:10.1007/s00256-024-04567-w

Lower extremity infections: Essential anatomy and multimodality imaging findings

Skeletal Radiol. 2024 Oct;53(10):2121-2141. doi: 10.1007/s00256-024-04567-w. Epub 2024 Jan 20.

Authors

George R Matcuk Jr¹, Matthew R Skalski², Dakshesh B Patel³, Brandon K K Fields⁴, Leah E Waldman⁵, Paolo Spinnato⁶, Ali Gholamrezanezhad^{7

3}, Sanaz Katal⁸

Affiliations

¹ Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Ste M-335, Los Angeles, CA, 90048, USA. [email protected].
² Department of Radiology, Palmer College of Chiropractic - West Campus, San Jose, CA, 95134, USA.
³ Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA.
⁴ Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, 94143, USA.
⁵ Department of Radiology, Duke University School of Medicine, Durham, NC, 27705, USA.
⁶ Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, 40136, Bologna, Italy.
⁷ Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Ste M-335, Los Angeles, CA, 90048, USA.
⁸ , Melbourne, Australia.

Abstract

In modern practice, imaging plays an integral role in the diagnosis, evaluation of extent, and treatment planning for lower extremity infections. This review will illustrate the relevant compartment anatomy of the lower extremities and highlight the role of plain radiographs, CT, US, MRI, and nuclear medicine in the diagnostic workup. The imaging features of cellulitis, abscess and phlegmon, necrotizing soft tissue infection, pyomyositis, infectious tenosynovitis, septic arthritis, and osteomyelitis are reviewed. Differentiating features from noninfectious causes of swelling and edema are discussed.

Keywords: Abscess; Cellulitis; Imaging; Lower extremity infection; Osteomyelitis; Septic arthritis.

Publication types

Review

MeSH terms

Diagnosis, Differential
Diagnostic Imaging / methods
Humans
Lower Extremity* / diagnostic imaging
Multimodal Imaging* / methods
Soft Tissue Infections / diagnostic imaging