The incidence of multilevel non-contiguous spine injury using whole spine MRI imaging is 17.76%. Five different patterns of multi-level non-contiguous injuries were found with the most common pattern being the cervical and thoracic level injuries. The incidence of unstable injuries can be as high as 21% of missed secondary injuries.

Routine T2 whole spine screening MRI identified 15.8% IF of the spinal and extra-spinal regions. 65 patients (4.3%) required either spine surgical intervention or other specialist care. Considering the potential advantages in identifying significant IF and the minimal extra time spent to perform whole spine screening, its application can be considered to be incorporated in routine imaging of spinal degenerative diseases.

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A 80-year-old female of moderate build who presented with complaints of pain, redness and severe swelling of the lids of left eye since 3 days following an insect bite. On examination she had severe edema of left eyelids extending to upper cheek area, blackish discoloration of lower periorbital skin. Slit lamp biomicroscopy did not reveal any abnormality in either of eyes. Microbiological investigations both examination of Gram stained smear and cultures did not show any microorganism. The patient was initially started on broad-spectrum intravenous antibiotics but did not show favourable response. Therefore, surgical debridement in two sittings followed by reconstruction with cheek rotation flap was performed. Patient responded favourably to surgical treatment. This case demonstrates that ophthalmologists should have high index of suspicion as necrotising fasciitis may occur following insect bite even in immuno-competent patients. Emergent surgical management coupled with parenteral broad spectrum antibiotics may limit ocular morbidity.

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