Diagnosis, Differential ; Fasciitis/genetics* ; Fibroma ; Humans ; Panniculitis

PURPOSE: To evaluate the sonographic findings of plantar fasciitis. MATERIALS AND METHODS: Both feet of 30patients(mean age, 44years) in whom plantar fasciitis had been clinically diagnosed, and those of healthyvolunteers(mean age, 34years) were evaluated with ultrasound(US) using a 7.0MHz linear array transducer. Heel painwas unilateral in 26 patients and bilateral in four. Sagittal sonograms were obtained in the prone position, andthe thickness of the plantar fascia was measured at its proximal end near its insertion into the calcaneus. Wealso evaluated hypoechoic fascia, perifascial fluid collection, fiber rupture, calcaneal spur and calcifications. RESULTS: Plantar fascia thickness was significantly greater in the heels of patients with plantarfasciitis(3.2-8mm; mean, 5.1 +/-1.12) than in their asymptomatic heels(1.3-5mm; mean, 3.5 +/-0.78)(p<0.0001), inwhich it was similar to that of heels of patients in the control group(1.8-5mm; mean, 3.0 +/-0.71)(p<0.0001). Theproximal plantar fascia was hypoechoic in 31 symptomatic heels(91.2%), in four asymptomatic heels(15.4%), and innone of the patients in the control group. Calcaneal spurs were identified in sixteen symptomatic heels(47.1%),and in two which were asymptomatic(7.7%). Perifascial fluid collection was identified in only two symptomaticheels(5.9%). CONCLUSION: In plantar fasciitis, sonography demonstrates that the fascia is thicker as well ashypoechic. For the clinical diagnosis of planter fasciitis, US can therefore be used as an adjunct to clinicaldiagnosis.
Calcaneus ; Diagnosis ; Fascia ; Fasciitis ; Fasciitis, Plantar* ; Foot ; Heel ; Heel Spur ; Humans ; Prone Position ; Rupture ; Transducers ; Ultrasonography*

Necrotizing fasciitis is rare acute infection showing rapidly necrosis involve the subcutaneous tissue and fascia. If treatment is delayed, infection can spread to involve the subcutaneous tissue, skin, deep fascia, and even muscle in rapid sequence, resulting in widespread necrosis and moderate to severe systemic toxicity. Most commonly this disease presents in the extremities, trunk, and perineum; it is relatively rare in the head and neck regions. If not diagnosed and treated in its early stages, necrotizing fasciitis can be potentially fatal, with a motality rate approaching 40%. Historically, the clinical entity now referred to as necrotizing fasciitis was described in the literature under various name. : hospital gangrene, necrotizing erysipelas, streptococcal gangrene, suppurative fasciitis. Necrotizing fasciitis was first described by Wilson in 1952. We experienced 3 cases of necrotizing fasciitis and will report review of literature with diagnosis, treatment, complication and consideration.
Diagnosis ; Erysipelas ; Extremities ; Fascia ; Fasciitis ; Fasciitis, Necrotizing* ; Gangrene ; Head ; Neck ; Necrosis ; Perineum ; Skin ; Subcutaneous Tissue

Nodular fasciitis is a benign, reactive, myofibroblastic, proliferative process of unknown etiology. It presents as a solitary, painless, rapidly-growing nodule over several weeks' duration. The condition is self-limiting, and proper diagnosis is essential to avoid unnecessary aggressive treatment. Diagnosis is often a challenge because nodular fasciitis may be confused with a malignant tumor due to its aggressive clinical behavior and histological features. It is most commonly located on the extremities and then the trunk. Such lesions also usually occur in middle age and are rarely diagnosed in childhood. We report a case of recurrent nodular fasciitis that arose from subcutaneous tissue on the back of a pediatric patient.
Diagnosis ; Extremities ; Fasciitis* ; Humans ; Middle Aged ; Myofibroblasts ; Subcutaneous Tissue

Nodular fasciitis is a reactive, non-neoplastic lesion that is most commonly found in the subcutaneous or superficial fascia of the extremities and trunk. Head and neck lesions are relatively uncommon and reports vary from 7% to 15% depending on the authors. Nodular fasciitis grows quickly, and shows a pleomorphic spindle cell pattern with increased mitotic activity. Such factors lead to cases where the lesion is mistaken for a malignancy such as fibrosarcoma and the case may end up with unnecessarily aggressive treatments. The intent of this paper is to report a relatively rare case of nodular fasciitis occurring in the periorbital area and also to highlight the importance of accurate diagnosis and non-aggressive management of this benign lesion.
Diagnosis ; Extremities ; Fasciitis* ; Fibrosarcoma ; Head ; Neck ; Subcutaneous Tissue

We report here on a case of nodular fasciitis (NF) that was diagnosed by ultrasonography (US)-guided core needle biopsy in a 31-year-old man, and we include the US and computed tomographic (CT) findings and the histopathologic findings at US-guided core needle biopsy (CNB). We suggest that high-resolution US is useful for the detailed evaluation of NF in the superficial regions, such as the face, and US-guided CNB is useful for the definitive histologic diagnosis of NF without causing scarring.
Adult ; Biopsy, Large-Core Needle* ; Cicatrix ; Diagnosis ; Fasciitis* ; Humans ; Ultrasonography

Cranial fasciitis is a rare morphological variant of nodular fasciitis. It is characterized by a rapid growing fibroblastic proliferative lesion that develops chiefly in childhood. It has varying size and involves the soft tissues of the scalp and the underlying skull. Accurate diagnosis and surgical excision is the key to management. Prognosis is good with rare recurrence. We report a case of cranial fasciitis in the temporal fossa of a 20-month-old girl and present a review of the literature.
Diagnosis ; Fasciitis* ; Female ; Fibroblasts ; Humans ; Infant ; Prognosis ; Recurrence ; Scalp ; Skull

Necrotizing fasciitis is a rapidly progressing soft-tissue infection that affects the subcutaneous fascia and dermis, and characteristically spares the underlying muscle. Most cases represent a synergistic or mixed bacterial infection of aerobes and anaerobes. A variety of etiologies have been reported. Herein, two cases of necrotizing fasciitis of the right thigh secondary to perforated appendicitis, an extremely rare complication, are reported. Both cases recovered following aggressive surgical and medical therapies. The delay in diagnosis and radical surgical excision are frequent and significant contributory factors in the high reported mortality rate. A high index of suspicion, followed by prompt surgical intervention with broad-spectrum antibiotic therapy, seems to be the most important prognostic factor in these difficult cases.
Appendicitis* ; Bacterial Infections ; Dermis ; Diagnosis ; Fascia ; Fasciitis, Necrotizing* ; Mortality ; Thigh

Necrotizing fasciitis is an uncommon infection of the subcutaneous soft tissue and fascia. The infection is expands rapidly and is highly lethal, so an early diagnosis and a radical debridement of all affected tissues until healthy tissue is encountered is imperative. There are many diagnostic methods such as simple X-ray study, ultrsonography, computerized tomography and diagnostic multiple incisions, but nothing can disclose the extent of affected tissue definitely. Recently someone advocated that magnetic resonance imaging(MRI) is useful to diagnose necrotizing fasciitis. We could determine the extent of underlying infection in a patient with perineal necrotizing fasciitis by using preoperative MRI, and treat it by one surgical resection. We propose that MRI can be used to diagnose the necrotizing fasciitis early and to disclose the extent of affected tissue, to help determine the extent of resection.
Debridement ; Early Diagnosis* ; Fascia ; Fasciitis, Necrotizing* ; Humans ; Magnetic Resonance Imaging*

Fournier's gangrene is a life-threatening disorder characterized by necrotizing fasciitis of the perineal region. Because delay in diagnosis and treatment of this condition can be fatal, it is important not to overlook the symptoms. We present an unusual case of Fournier's gangrene after excision of a thrombosed hemorrhoid. A previously healthy 74-year-old female patient developed Fournier's gangrene after a hemorrhoidectomy. In spite of aggressive treatment, she eventually died. Here, we emphasize early recognition and prompt treatment of this condition, reporting an unexpected disastrous complication of a hemorrhoidectomy.
Aged ; Diagnosis ; Fasciitis, Necrotizing ; Female ; Fournier Gangrene* ; Hemorrhoidectomy ; Hemorrhoids* ; Humans