Reason: Infected ulcers, rule out osteomyelitis RIGHT TIBIA/FIBULA:There is ulceration of the lateral soft tissues of the lower leg and ankle with enhancement of the adjacent skin, indicating inflammation. The subcutaneous fat of the medial and lateral right ankle demonstrates heterogeneous signal, likely representing a combination of chronic scarring and edema. There is mild fatty atrophy of the calf musculature. We see no fluid collections within the soft tissues to indicate abscess. Chronic appearing periosteal bone formation is better seen on ankle radiographs. We see no edema within the bone to indicate osteomyelitis. Intermediate signal replaces the marrow on T1W images, likely reflecting red marrow replacement from sickle cell disease. Nonenhancing T2 hyperintense focus in the distal tibia may represent a degenerative cyst. There is a small amount of fluid in the right knee joint.LEFT TIBIA/FIBULA: There is ulceration of the soft tissues along the medial and lateral aspects of the ankle/lower leg with enhancement of the skin along the medial aspect of the ankle. Heterogeneous signal within the subcutaneous fat likely represents a combination of chronic scarring and edema. There is mild fatty atrophy of the calf musculature. We see no fluid collections within the soft tissues to indicate abscess. There is periosteal bone formation along the distal tibia/fibula but we see no abnormal bone marrow signal to indicate osteomyelitis. Intermediate signal replaces the marrow on T1 images, likely reflecting red marrow replacement from sickle cell disease.
Cellulitis and soft tissue ulceration without evidence of osteomyelitis.