Female, 87 years old. Reason: eval for osteomyelitis History: left ankle with open wound, purulence, exposed tendon, and CRP 240 There is extensive soft tissue edema about the ankle with associated obliteration of the normal pre-Achilles fat posterior to the ankle joint. Mild heterogeneous soft tissue enhancement diffusely suggests an ongoing inflammatory process. On postcontrast images, an area of low signal in the superficial soft tissues anterior to the distal tibia with peripheral enhancement may reflect a fluid collection within the soft tissues. A small amount of fluid is noted within the retrocalcaneal bursa. Increased T2 signal within the sinus tarsus may reflect additional inflammation.The underlying osseous structures are intact, with and normal cortical thickness and bone marrow signal. The visualized tendons of the ankle are intact. The anterior talofibular ligament is not well visualized. A small ankle joint effusion is noted.
1.Diffuse soft tissue inflammation/edema, without evidence of osteomyelitis.2.Possible small fluid collection in the superficial soft tissues anterior to the distal tibia.