Female 81 years old with right ankle pain and radiograph showing periosteal reaction. Evaluate for osteomyelitis. The study was ordered with contrast but the patient declined contrast at the time of the exam. ARTICULAR SURFACES AND BONE: Soft tissue ulceration along the lateral ankle measures approximately 3 cm in AP and 5 cm in craniocaudal dimension. The marrow signal in the underlying fibula is normal.There is narrowing, sclerosis and cyst formation at the articulation of the medial cuneiform and the navicular bone as well as at the median cuneiform - second metatarsal joint and lateral cuneiform - third metatarsal joint indicating osteoarthritis. No fractures are identified. There is no tibiotalar joint effusion.TENDONS: The Achilles tendon, flexor and extensor tendons are normal in appearance.LIGAMENTS: The lateral ligaments and deltoid ligament are intact.ADDITIONAL
Soft tissue ulceration but no evidence of osteomyelitis.