58-year-old male with history of chronic osteomyelitis and medication noncompliance presents with altered mental status and elevated white blood cell count, evaluate for progression of chronic osteomyelitis. Again seen is ulceration of the soft tissues posterior and inferior to the calcaneus. The margin of the posterior calcaneus is less distinct on the current study compared to the prior compatible with stated history of osteomyelitis which was confirmed on MRI study dated 9/10/2015. Additionally, there has been development of a new pathologic fracture through the superior aspect of the posterior calcaneal tuberosity with approximately 1 cm anterosuperior displacement of the retracted fracture fragment. There is thickening of the adjacent Achilles tendon. The bones appear demineralized suggestive of osteopenia. Arterial calcifications are noted in the soft tissues.
Soft tissue ulceration with osteomyelitis at the calcaneus and a new pathologic fracture through the superior aspect of the posterior calcaneal tuberosity.The above findings were communicated via telephone to Mark Belkin, MD at 09:13 AM on 11/03/2015. 