2-year-old male with concern for osteomyelitis in the distal left tibia Coronal T1-weighted imaging of the bilateral lower extremities demonstrates multiple abnormalities in bone marrow signal intensity in the tibiae, localized in the proximal and distal metadiaphyses bilaterally. Coronal STIR imaging of the bilateral lower extremities shows signal abnormality in a similar distribution, with additional signal abnormality in the soft tissues of the ankles, left greater than right. Dedicated axial and sagittal imaging of the left lower extremity shows geographic serpiginous pattern of enhancement of some of the foci of signal abnormality in the left tibia. No fracture or malalignment is seen.
Multiple bilateral tibial bony infarcts of indeterminate chronicity with probable superimposed osteomyelitis of the left ankle.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.