Lower extremity wound Examination is limited by motion artifact on multiple sequences.There is a large ulceration of the anterolateral soft tissues of the leg at approximately the level of the junction between the upper and middle thirds. The ulceration extends into the tibialis anterior muscle and appears to disrupt the central tendon. There is edema and enhancement of the tibialis anterior muscle and adjacent soft tissues. The ulceration extends to within a couple of millimeters of the anterior tibial cortex where there is a small defect as seen on the recent radiographs. While this may represent an erosion related to the ulceration, there is no abnormal marrow signal intensity in the underlying bone to confirm osteomyelitis. This defect may be posttraumatic in nature.The fibula appears normal. There is subcutaneous edema extending laterally down the leg into the ankle. There are no additional fluid collections separate from the ulceration. Small foci of signal void along the margins of this ulceration may represent foci of gas or less likely tiny metallic foreign bodies. Subcutaneous edema is also noted along the medial ankle.
Soft tissue ulceration with extension into the tibialis anterior muscle and a small superficial cortically-based defect of the adjacent tibia. While this defect could represent erosion due to the ulceration, there is no abnormal signal intensity to confirm osteomyelitis and it is possible this defect is posttraumatic in nature.