Fluoroscopy and MRI Induced Skin Injuries: A Review of Diagnostic, Management, and Preventative Principles

Abstract

The clinical applications of fluoroscopy and MR imaging for interventional and diagnostic purposes are rapidly expanding, necessitating a renewed awareness of iatrogenic radiologic skin injuries. This article reviews the risk factors, clinical characteristics, and management strategies for imaging related skin injury relevant to radiologists. Skin injuries resulting from diagnostic imaging or radiologic interventions are rare complications that receive relatively little attention in the medical literature, but confer significant morbidity. The clinical signs of radiation skin reactions may not present for several weeks to months following exposure, beyond the time frame of typical follow-up for most interventional procedures. Increased vigilance and enhanced follow-up protocols are needed to detect clinically relevant skin reactions. An interdisciplinary management approach involving wound care specialists, dermatologists, and plastic surgeons may be warranted. The predictable relationship between fluoroscopic radiation dose exposure and extent of injury, and patient characteristics and equipment with burns when undergoing MRI allows for the determination when practical follow-up approaches are necessary to mitigate harmful long lasting effects.