Visual Diagnosis in Emergency Medicine| Volume 48, ISSUE 4, P468-469, April 2015

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Posttraumatic Subcutaneous Emphysema: In Need of Immediate Surgical Debridement or a Careful History?

Published:February 02, 2015DOI:
      A 32-year-old healthy woman was referred to our Emergency Department (ED) for concern of a necrotizing soft tissue infection (NSTI). Two days earlier, she suffered a laceration on the lateral aspect of her right ankle during a bicycle accident. She irrigated it with an over-the-counter cleaning solution, and after noticing redness around the wound, went to an urgent care center where radiographs revealed air in the soft tissue near the laceration. Physical examination demonstrated a well-appearing woman who was afebrile with normal vital signs. Her ankle had a small laceration with surrounding erythema, obvious crepitus, and mild tenderness to palpation. Laboratory analysis, including C-reactive protein and erythrocyte sedimentation rate, was unremarkable. Her radiograph is seen in Figure 1.
      Figure thumbnail gr1
      Figure 1Plain radiograph of the right ankle. The arrow indicates the location of the subcutaneous emphysema around the lateral malleolus.
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