66-year-old female with chronic open wound, evaluate for osteomyelitis of the right tibia There is a focal defect in the skin along the anterior aspect of the distal tibial diaphysis which likely represents the patient's chronic ulcer. This lesion extends deep into the adjacent tibia where there is increased T2 signal, enhancement and destruction of the anterior cortex, consistent with osteomyelitis. Diffuse edema is seen within the anterior subcutaneous tissues at the level of the ulcer with enhancement, which is nonspecific but may suggest cellulitis. Nonenhancing edema is seen in the posterior and lateral subcutaneous tissues more superiorly. However, no focal fluid collection is evident to suggest abscess formation. A small joint effusion is seen within the visualized knee. The fibula appears intact
Anterior ulcer along the distal leg extending into the adjacent tibia, compatible with osteomyelitis.