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Hyperflexion Teardrop Injury
Joseph Junewick, MD FACR
over 8 years ago
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Case History


Newborn with indurated and erythematous skin over the back 1 week after therapeutic cooling for perinatal asphyxia.


Case Detail

Anatomy: Musculoskeletal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Infectious-Inflammatory
Created: over 4 years ago
Updated: over 4 years ago
Tags: PEDS
Modality/Study Types: CT MR
Activities:
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Case Images


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Reveal 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.

Reveal 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.

Reveal Diagnosis

Fat Necrosis

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