61-year-old female with history of IO placement within the right tibia now with concern for cellulitis and osteomyelitis. There is branching signal abnormality and enhancement within the proximal tibia extending from the tibial plateau into the proximal diaphysis over a craniocaudal distance of approximately 11 cm compatible with osteomyelitis. There is less well-defined signal abnormality which is appreciated within the distal tibia along with small round foci of enhancement which may also represent infection.There is a large knee joint effusion with mild synovial enhancement. Please note that we cannot exclude the possibility of a septic joint. There is a small Baker cyst.There is edema and enhancement of the soft tissues of the upper leg appearing similar to the prior MRI exam. A small fluid collection is present within the subcutaneous fat adjacent to the tibial tuberosity measuring approximately 1.5 x 0.7 cm in the transverse dimension and 2.5 cm craniocaudally which may represent a small abscess. There is also edema within the soft tissues of the distal thigh particularly between the vastus lateralis and biceps femoris.
1.New signal abnormality within the bone marrow of the tibia compatible with osteomyelitis.2.Soft tissue inflammatory changes as described above including a small abscess along the medial aspect of the tibial tuberosity.Findings discussed with Dr. Davey at 0930 on 1/13/15.