Evaluate for osteomyelitisIMAGE ACQUISITIONS: CT- right hip, bilateral foot and ankle. Please note that the patient presented with a history of possible osteomyelitis with draining ulcers. An MRI with contrast was suggested to evaluate the right hip and bilateral foot and ankles. However, after conference with the primary service, our request for an MRI was modified and a CT with no enhancement was performed at the service's request.CT of the right hip shows a deep ulcer overlying the greater trochanter extending to the level of the bone with minimal cortical destruction and associated soft tissue gas. These findings are suspicious for osteomyelitis.CT of the right foot and ankle shows what appears to be a shallow soft tissue defect consistent with an ulcer overlying the medial and lateral malleoli. The underlying bony cortex appears intact. Vascular calcifications are noted. Degenerative changes affect the foot and ankle.CT of the left foot shows no ulceration, discrete abscesses or other radiographic findings to suggest osteomyelitis. Slight fat stranding about the foot is consistent with soft tissue edema. The patient is status post mid first metatarsal amputation with the osteotomy edge remaining intact.
1) Deep ulcer overlying the greater trochanter extending to the level of bone with minimal cortical destruction and associated soft tissue gas suspicious for osteomyelitis. 2) Shallow ulcers overlying the medial and lateral malleoli of the right foot with no evidence of cortical disruption.