Male 53 years old; Reason: known osteomyelitis in R foot, now septic with unclear source. Red, painful leg. RIGHT FOOT: The patient is status post amputation of the fourth ray through the fourth metatarsal, and status post amputation of the distal half of the fifth metatarsal. There are associated soft tissue changes including scarring and foci of metallic susceptibility artifact. Soft tissue defect at the lateral aspect of the forefoot near the site of the fifth metatarsal amputation with underlying signal abnormality in the soft tissues possibly represents a combination of scarring and inflammation. No discrete fluid collection is seen to suggest abscess. No marrow signal abnormality is seen to confirm osteomyelitis. Edema is present in the dorsal soft tissues of the foot. Mild edema and atrophy of the plantar musculature of the foot is noted. There are foci of metallic susceptibility artifact in the plantar soft tissues beneath the first metatarsal neck, which limit evaluation of the surrounding structures.RIGHT TIBIA/FIBULA: There is edema within the subcutaneous fat. Mild signal abnormality in the musculature likely represents a combination of atrophy and edema. No fluid collection is seen to suggest abscess. The bone marrow signal is normal. No findings are seen to confirm osteomyelitis. A knee joint effusion is seen, though incompletely imaged on this exam. Similar findings are noted in the contralateral leg on the large FOV series.
Postoperative and soft tissue inflammatory changes, as described above. No findings to suggest osteomyelitis.