1. ULTRASOUND OF THE WEEK Cellulitis vs. Abscess
Cellulitis, or inflammation of the subcutaneous connective tissue, is described sonographically as a cobblestone street.

2. Which probe?
Linear
Why?
High frequency (good resolution in the near field)

3. Classic “cobblestoning” seen in cellulitis

4. 1) Irregular, hypoechoic collection 2) Enhancement 3) Squish
With abscesses, we are looking sonographically for:
An irregular, hypoechoic collection, as indicated by the arrowheads.
And, posterior acoustic enhancement, as indicated by the arrows.
1) Irregular, hypoechoic collection 2) Enhancement 3) Squish

5. ACOUSTIC ENHANCEMENT 3rd Rock Ultrasound
With fluid collections, there is efficient propagation of ultrasound waves.
As ultrasound passes through a medium that causes less attenuation, such as an abscess, this results in a greater amount of acoustic energy available to continue the journey.
This results in a similar increase in echogenicity immediately posterior to the abscess.
Module 10 – First Trimester Pregnancy

6. SQUISH SIGN 3rd Rock Ultrasound
One helpful trick when evaluating for an abscess is to apply very gentle downward pressure over the area. If you see movement of pus within the lesion, this tells you it is definitely an abscess.
Module 10 – First Trimester Pregnancy