Reason: rule out osteomyelitis History: infected LLE venous stasis ulcer RIGHT ANKLE: Again seen is ulceration along the lateral aspect of the right ankle with heterogeneity of the underlying fat, which likely represents a combination of chronic scarring and edema. There is signal abnormality of the marrow of the distal tibia/fibula, which likely represents residual/reconverted red marrow. We see no specific findings to suggest osteomyelitis. We see no fluid collections to indicate abscess. A small focus of signal abnormality in the distal tibia may represent a cyst. Additional patchy signal abnormality indicates red marrow within the bones of the foot. Low signal along the posterior medial ankle likely represents chronic scarring. There is a small volume of fluid in the tibiotalar joint but no large effusion. Linear increased signal in the Achilles tendon suggests mild tendinosis.LEFT ANKLE: Ulceration along the medial and lateral aspects of the ankle with heterogeneity of underlying fat likely represents a combination of edema and chronic scarring. Signal abnormality of the marrow of the distal tibia/fibula likely represents residual/reconstituted red marrow but we see no specific findings of osteomyelitis. We see no fluid collections or abscess. Additional patchy signal abnormality in the bones of the foot represents additional red marrow. The visualized tendons appear normal. There is atrophy of the muscles of the ankle with what appears to be an anomalous muscle extending to the calcaneus.
Soft tissue ulceration and bony sequelae of sickle cell disease without specific radiographic findings of osteomyelitis.