Reason: evaluate for osteo History: edema, r/o osteo There is soft tissue irregularity along the plantar aspect of the calcaneus consistent with known history of ulceration. There is decreased signal abnormality on T1 and T2 along the plantar aspect of the calcaneus likely representing scarring/granulation tissue. Although this signal abnormality extends to the level of the plantar aspect of the calcaneus, no bone marrow signal abnormalities are identified to suggest osteomyelitis. There is additional ulceration along the dorsal and lateral aspect of the midfoot. There is low signal intensity internally which may represent packing material or granulation tissue. There is no evidence of osteomyelitis of the underlying bones of the midfoot/ankle. There is nonspecific increased signal abnormality and fluid sensitive sequences within the plantar musculature of the foot as can be seen in diabetic patients or in myositis/inflammatory change. There is circumferential fluid within the tendon sheath of the extensor digitorum longus indicating acute synovitis. There is an apparent fluid collection within the subcutaneous tissue along the anterior aspect of the extensor tendons measuring approximately 3.4 x 1.0 x 5.5 cm which is suspicious for abscess formation, although this is incompletely characterized on this noncontrast examination. This collection extends distally along the dorsal and lateral aspect of the midfoot.Osteoarthritis affects the tarsometatarsal articulations with degenerative subchondral signal abnormality. There is a small amount of fluid within the tibiotalar and subtalar joints but no evidence of a large effusion. There is nonspecific increased signal abnormality within the muscle belly of the flexor hallucis longus at the level of the myotendinous junction. The lateral collateral ligament complex appears intact. The distal tibiofibular syndesmotic complex appears intact. Imaged components of the deltoid ligament appear intact.
1. Ulceration and subcutaneous inflammatory change about the plantar aspect of the calcaneus as well as along the dorsolateral aspect of the ankle/midfoot, without evidence of osteomyelitis. Fluid collection within the subcutaneous tissue along the anterior and lateral aspect of the ankle extending along the dorsal and lateral aspect of the midfoot is suspicious for abscess formation, although this is incompletely characterized on this noncontrast examination.2. Findings indicating extensor digitorum longus tenosynovitis. Other findings as described above.