Female 8 years old Reason: concern for osteomyelitis History: pain, swelling, fever, elevated ESR/CRP A circumferential complex subperiosteal fluid collection surrounds the distal fibular diaphysis and metaphysis measuring approximately 6 mm in maximal thickness and 4.8 cm in craniocaudal dimension. Area of relative decreased signal within the subperiosteal fluid collection suggestive of pus/debris. The underlying fibular metadiaphysis demonstrates mottled decreased T1 marrow signal and punctate foci of high T2 signal as well as enhancement and edema of the surrounding subcutaneous fat and musculature. These findings are compatible with a subperiosteal abscess and osteomyelitis. Overlying skin thickening and edema of the subcutaneous fat suggestive of cellulitis. A small joint effusion is present.
1.Osteomyelitis of the distal fibular metadiaphysis with an associated subperiosteal abscess.2.Findings consistent with cellulitis.3.Small joint effusion.