PMC4801093_01
T2 weighted MRI of the chest showing enhancing area of the necrotic tissue over the right sixth rib, with underlying phlegmonous changes.
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F1
Preoperative magnetic resonance imaging (MRI) demonstrated an enhancing collection overlying the sixth rib at the right anterior chest wall, phlegmonous changes involving the anterior and lateral right chest wall, and an oblique sinus tract extending from the collection to the seventh costal cartilage with an associated rib fracture (Fig. 1).
Anterior chest wall with surrounding erythema, swelling, and skin breakdown.
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F2
When reviewed 2 weeks after discharge, the surgical wound remained tender, swollen, and warm (Fig. 2).
Debridement and resection of the fifth and sixth intercostal cartilages.
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F3
During the admission, he developed skin breakdown and cellulitis over the affected area, and he was taken back to the theatre for further debridement and washout plus resection of his right anterior fifth and sixth ribs (Fig. 3).