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The objective of this presentation is to review the importance of triple assessment in fat necrosis. At least six confirmed cases will be presented demonstrating the importance of an accurate clinical history/examination, high quality imaging and pathological correlation. The ultrasound findings demonstrate a common theme of irregular fluid collections extending across tissue planes. In particular this presentation: (1) highlights the ultrasound features which should alert the sonographer to a diagnosis of fat necrosis which may otherwise be obscure; and (2) demonstrates how these features are part of the triple assessment process.