From the Research
To rule out a scalp infection, I recommend starting with a clinical examination and microbiological testing, and if deeper infection is suspected, using MRI as the imaging modality of choice, as it is highly sensitive and specific in detecting soft tissue and bone infections, as supported by the most recent study 1. When evaluating a patient for a scalp infection, it's essential to consider the clinical presentation, including symptoms, appearance of the affected area, and risk factors for specific types of infections.
- The initial approach should include a thorough clinical examination, followed by skin scrapings or swabs for microscopy and culture, as these are crucial in identifying the causative organism and guiding antibiotic therapy.
- If a deeper infection is suspected, imaging may be necessary to assess the extent of the infection and potential complications.
- Among the imaging modalities, MRI is preferred due to its high sensitivity and specificity in detecting soft tissue and bone infections, as well as its ability to differentiate between various types of infections, such as cellulitis, abscess, and osteomyelitis 2.
- While CT scans can also be useful, particularly in cases where MRI is not available or contraindicated, MRI remains the gold standard for diagnosing acute osteomyelitis and other complex infections 1.
- Ultrasound can be useful in identifying abscesses or fluid collections, but its depth of penetration is limited, making it less suitable for evaluating deeper infections.
- Blood tests, including complete blood count, C-reactive protein, and erythrocyte sedimentation rate, can help assess the severity and systemic impact of the infection, but should not be relied upon as the sole diagnostic tool. The choice of diagnostic test should be guided by the clinical presentation, and MRI should be considered the primary imaging modality for evaluating suspected scalp infections, especially when deeper tissue involvement is suspected, as supported by the most recent and highest quality study 1.