Right distal tibia and distal femur osteomyelitis after old MVA. Evaluate for acute changes. Two views of the right femur show deformity of the femoral diaphysis likely due to old healed fractures, appearing similar to the prior study, with anterior bowing deformity of the mid-diaphysis. Screw fragments are noted within the mid-femoral diaphysis. Two screws affix a patella fracture in near-anatomic alignment. Heterotopic calcification is noted in the soft tissues lateral to the ilium, unchanged. Moderate osteoarthritis affects the knee. We see no acute process in the femur.Two views of the right tibia/fibula show old postoperative deformity of the right tibia/fibula reflecting healed fractures, appearing similar to the prior study. There is a geographic lucency within the distal tibial metadiaphysis that corresponds to an intramedullary lesion of near fluid signal intensity on a recent outside hospital MRI. This appears more prominent on the current study than the prior study and we cannot exclude an intramedullary abscess.
1. Post-traumatic deformities as described above.2. Geographic lucency in the right distal tibial metadiaphysis corresponding to a fluid signal intensity lesion on prior OSH MRI appears more prominent on this examination; we cannot exclude an intramedullary abscess.