Possible wound infection versus osteomyelitis. History of stump infections. Fell today. Bilateral BKA secondary to diabetes. Several sequences are limited by motion artifact.Patient is status post right below-the-knee amputation. There appears to be a small skin defect of the distal stump (series 5, images 11-13). The subcutaneous fat of the stump distal to the tibia demonstrates intermediate signal intensity on T1-weighted images, mixed signal intensity on T2-weighted images, and enhancement on postcontrast images. This likely represents a combination of inflammation and scarring. However, the underlying marrow signal intensity of the adjacent tibia appears normal on T1-weighted images without evidence of osteomyelitis. The marrow intensity of the fibula likewise appears normal.No rim-enhancing fluid collection is present to suggest abscess. Overall there is expected fatty atrophy of the musculature of the leg with mild edema of the remaining tibialis anterior muscle, which is nonspecific. Mild edema and enhancement of the lateral aspect of the patella may represent a bone contusion.Postoperative changes of left below-the-knee amputation are also noted, without evidence of osteomyelitis of the left tibia or fibula.
1.Mild inflammatory changes of the distal soft tissues of the stump, without evidence of abscess or osteomyelitis.2.Mild edema and enhancement of the patella may represent contusion.