Reason: osteo History: osteo There is thickening and enhancement of the skin along the anteromedial aspect of the distal tibial diaphysis likely representing the site of ulceration and adjacent inflammation/scarring. The signal abnormality and enhancement extends to the anteromedial cortex of the distal tibial diaphysis, but we see no frank cortical penetration nor do we see findings to suggest osteomyelitis of the underlying medullary bone. There is diffuse low to intermediate signal intensity within the medullary space of the tibial diaphysis likely representing residual red marrow related to the patient's known history of sickle cell disease. Additionally, there are multiple areas of bone infarction including one adjacent to the aforementioned site of ulceration, which is new when compared to the prior study. We see no fluid collection within the soft tissues to indicate abscess formation. There is mild fatty atrophy of the musculature of the calf.
Superficial soft tissue inflammation and other findings as described above, but no evidence of osteomyelitis.