Ulcer on right lateral malleolus. Osteo-? Markers were placed along the lateral aspect of the lower leg and ankle denoting the area of interest. Please note that the field-of-view was adjusted accordingly, and the inferior margins of the talus and calcaneus are not included on the field-of-view of this study. There is ulceration of the soft tissues along the lateral aspect of the distal fibula. A collection of nonenhancing tissue, perhaps representing pus, extends from the skin defect to the underlying fibular cortex. There is edema and enhancement surrounding this collection indicating inflammation, but I see no signal abnormality within the underlying fibula to indicate osteomyelitis. The nonenhancing collection continues tracks deep to the peroneal tendons along the posterior margin of the fibula. The peroneal tendons themselves, however appear intact and I see no tenosynovitis. There is diffuse subcutaneous edema, as well as mild edema and enhancement of the musculature of the ankle indicating inflammation, but I see no discrete rim-enhancing fluid collection to indicate a drainable abscess.
Soft tissue ulceration and inflammatory changes of the right ankle as described above, including a sinus tract/phlegmon that extends from the skin surface to the fibula; however, I see no bone marrow signal abnormality to indicate osteomyelitis.