62-year-old female with chronic bilateral lymphedema and lower extremity wounds/ulcers with pseudomonas. Rule out osteomyelitis. Presents with pain. There is diffuse subcutaneous edema which appears most pronounced along the medial aspect of the leg. Some of this edema becomes confluent along the medial aspect of the tibiotalar joint and along the lateral aspect of the fibular tip, however, no organized or drainable fluid collection is identified to suggest abscess formation. However, it should be noted that evaluation for abscess formation is limited on this noncontrast examination. There is also increased signal abnormality within the medial and lateral head of the gastrocnemius which may represent edema or a myositis. There is fatty atrophy about the leg most pronounced within the gastrocnemius muscle. The imaged tendons appear grossly intact. Although this examination was not protocoled for detailed evaluation of the knee, there is near full-thickness articular cartilage degeneration affecting the patellofemoral joint with underlying degenerative signal abnormality and subchondral cyst within the patella indicating severe osteoarthritis. There are tricompartmental osteophytes. Otherwise, no bone marrow signal abnormality is identified. Specifically, there is no bone marrow signal abnormality to suggest osteomyelitis. There is also nonspecific subcutaneous edema about the right lower extremity as seen on the large field-of-view images.
1. Diffuse subcutaneous and soft tissue edema about the leg which is nonspecific but consistent with the stated history of a cellulitis/myositis. No findings to suggest osteomyelitis or abscess formation.2. Degenerative osteoarthritic changes of the left knee. Other findings as described above.