Reason: 19-year-old male with history of NK/T-Cell lymphoma s/p transplant with recurrent osteomyelitis now with bilateral foot pain History: 19-year-old male with history of NK/T-Cell lymphoma s/p transplant with recurrent osteomyelitis now with bilateral foot pain There is perhaps soft tissue irregularity along the lateral aspect of the ankle which may represent ulceration. There is minimal nonspecific enhancing subcutaneous edema most pronounced along the lateral aspect of the ankle which may represent a cellulitis in the correct clinical context, but this is of questionable clinical significance. There is no evidence to suggest osteomyelitis of the underlying bone. Note is made of multiple serpentine foci of signal abnormality within the distal tibia, talar dome, calcaneus, navicular, cuboid, and bases of the first and fourth metatarsals consistent with osteonecrosis/bone infarcts. No osteochondral defects are identified. There is nonspecific diffuse edema affecting the imaged musculature of the ankle and foot involving both the flexor and extensor compartments. While these findings are nonspecific they may represent a myositis. The lateral collateral ligament complex appears intact. The distal tibiofibular syndesmotic complex appears intact. The imaged components of the deltoid ligament appear intact.
1. Extensive bone infarcts affecting the right ankle and midfoot as described above. There is no evidence of osteomyelitis.2. There is diffuse edema within the imaged musculature of the right ankle and foot which is nonspecific but may represent a myositis.3. Minimal soft tissue ulceration and subcutaneous edema may reflect a cellulitis in the correct clinical context, however, no focal fluid collection is seen to suggest abscess formation.