Imaging features of anorectal proctitis in monkeypox infection

The monkeypox outbreak of 2022 saw the first community-sustained transmission of the monkeypox virus outside of Africa, and rapidly developed into multi-country spread. A common presenting sign of monkeypox infection during this outbreak has been rectal pain due to proctitis. Proctitis with large hypoattenuated anorectal ulcers on CT scan should invoke consideration for monkeypox infection in young homosexual or bisexual men with associated skin eruptions. •The monkeypox outbreak of 2022 has predominately affected young homosexual and bisexual men.•Rectal pain due to proctitis is a frequent presenting symptom of monkeypox.•Proctitis with hypoattenuated anorectal ulcers on CT with associated skin eruption should evoke consideration for monkeypox infection.