Frostbite: spectrum of imaging findings and guidelines for management.

  • The primary role of imaging in frostbite is to define the severity and extent of tissue injury.
  • Radiographs are used as an initial survey.
  • Frostbite is most common in middle-aged men and is frequently complicated by homelessness, mental illness, and substance abuse.
  • Frostbite is divided into degrees of injuries similar to thermal burn injuries.
    • First and 2nd° being superficial and third and fourth-degree representing deep injury.
  • Radiographic stages are divided it into early (immediate two weeks), intermediate (weeks to months) and late (months to years).
  • tPA reperfusion shows promise and can be performed for 48 hours at 12-hour intervals. The interval helps assess for stenoses due to spasm versus genuine vascular injury.
  • Multiphase bone scan should be performed between two and four days after the initial injury or after angiography in patients who undergo from thrombolysis. A repeat scan in 7 to 10 days can help with decisions about surgical resection.
    Nuclear medicine uptake patterns depend on the injury.
  • SPECT-CT offers the most anatomic resolution and best definitive assessment of tissue viability for surgical amputation or debridement.
  • Source

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