62-year-old female patient with penetrating injury and complicated soft tissue infection of the right leg. Evaluate for osteomyelitis. There is a wound along the anterior aspect of the lower leg that extends through the subcutaneous fat to the underlying anterior compartment musculature. There is thickening and enhancement of the adjacent skin as well as enhancement of the adjacent subcutaneous fat, indicating inflammation. There are thin, nonenhancing tracts extending from the wound into the anterior compartment musculature, but we see no drainable fluid collection in this area. There is inter- and intramuscular edema involving the anterior compartment musculature as well as a small amount of edema and enhancement involving the adjacent deep posterior compartment musculature. There is a 4 mm rim-enhancing collection between the distal fibula and the posterior tibialis tendon that may represent a small phlegmon, but we see no drainable abscess. The bone marrow signal intensity is normal and we see no evidence of osteomyelitis.
Anterior soft tissue ulceration with inflammatory changes of the underlying soft tissues, including peripherally enhancing tracts extending from the wound into the anterior compartment musculature that could represent intramuscular extension of infection. We see no drainable abscess or findings of osteomyelitis.