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Neonatal Fat Necrosis
Case Detail
| Anatomy: Musculoskeletal |
 Joseph Junewick, MD FACR |
| Diagnostic Category: Infectious-Inflammatory |
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| Created: over 4 years ago |
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| Updated: over 4 years ago |
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| Tags:
PEDS
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| Modality/Study Types:
MR
CT
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Activities:  PDF  ImageJA |
History
Newborn with indurated and erythematous skin over the back 1 week after therapeutic cooling for perinatal asphyxia.
Case Images
Diagnosis
Fat Necrosis
Findings
MR – Axial T2 image shows edema (arrowheads) at subcutaneous fat and muscular fascia interface.
CT – Axial noncontrast image shows extensive calcification of the subcutaneous soft tissues.
Discussion
Erythematous or violceous non-suppurative subcutaneous nodules with induration of the skin one-two weeks after a complicated perinatal period (usually asphyxia, meconium aspiration, or eclampsia) are characteristic of fat necrosis. Brown fat is more prevalent in the newborn and more prone to fat necrosis from therapeutic hypothermia because of higher concentrations of palmic and stearic acids compared to yellow fat. Mechanical pressure associated with therapeutic cooling impairs reperfusion after issue hypoxia. Edema and dystrophic calcifications may be seen on imaging. Both clinical and imaging findings usually resolve over several months.
Reference
Srinath G, Cohen M. Imaging findings in fat necrosis in a newborn. Pediatr Radiol (2006); 36:361-363.