Diagnosis of eosinophilic fasciitis (EF), a rare sclerosing disorder with fascial inflammation, is traditionally predicated on a full-thickness wedge biopsy. This can be difficult to obtain and presents wound healing challenges in sclerotic skin. Magnetic resonance imaging (MRI) is an alternative for evaluating fascial involvement in EF that has not previously been compared to a wedge biopsy.
A retrospective review of 54 patients with a diagnosis of EF was conducted to evaluate detection of fascial involvement by MRI and/or wedge biopsy. Thirty-nine patients met inclusion criteria for this study.
Of the 39 patients included, 61.5% (n=24) had a wedge biopsy, 67% had an MRI, and 38.5% (n=15) had both a wedge biopsy and an MRI. Of those 15 patients, 12 patients (80%) had evidence of fascial involvement detected by both modalities. Overall, MRI had a sensitivity of 92.3% while wedge biopsy had a sensitivity of 91.7% in detecting fascial changes suggestive of EF.
Our data proposes that MRI may be noninferior to wedge biopsy for diagnosis of EF. Furthermore, MRI may be more favorable clinically given its less invasive nature and the potential to monitor treatment response over time.