Reason: Patient with R. ankle wound and drainage, please evaluate for osteomyelitis History: Leg pain There is diffuse subcutaneous edema throughout the ankle and extending distally along the dorsum of the foot. There is irregularity of the skin superficial to the lateral malleolus which may represent ulceration. There may also be ulceration of the skin anterior to the distal tibia. There is minimal increased signal intensity seen within the underlying lateral malleolus on the fluid sensitive sequences, but this likely represents reactive osteitis rather than osteomyelitis as the fat signal on the T1-weighted images is preserved. There is patchy increased signal intensity within the marrow of the talus, calcaneus, and medial cuneiform bones which may be degenerative in etiology and does not have the appearance of osteomyelitis. There is a small amount of fluid in the tibiotalar joint but no large effusion. There is also soft tissue edema deep within the ankle surrounding and within the distal flexor hallucis longus muscle. Although the edema becomes confluent, we see no focal fluid collection to confirm abscess. There is minimal fluid in the sheaths of the medial and lateral tendons but the tendons otherwise appear normal. There is also edema of the plantar musculature of the foot, which is nonspecific.
Soft tissue swelling and ulceration without specific imaging features of osteomyelitis.