Actinomycosis is a chronic, suppurative infection caused by Actinomyces species. These anaerobic Gram-positive bacteria are part of the normal flora of the oral cavity, gastrointestinal tract, and female genital tract. It is characterised by its ability to breach anatomical barriers, causing abscesses, fistulas, and sinus tracts. Cervicofacial actinomycosis accounts for 50–65% of cases, followed by thoracic (15–30%) and abdominopelvic (20%) forms, with rare involvement of the CNS and musculoskeletal system [1, 2].

The clinical presentation varies widely, often mimicking malignancies or other infections. Radiologic modalities like CT and MRI play an essential role in diagnosis, offering key insights into features such as invasive soft-tissue masses, rim-enhancing abscesses, and fibrotic lesions. MRI's “dot-in-circle” sign is considered pathognomonic for musculoskeletal involvement [3, 4]. Early diagnosis facilitates appropriate antibiotic therapy and minimises unnecessary surgical interventions [5, 6].