Sickle cell crisis. Evaluate for osteomyelitis. Examination of the images reveal an abundance of red marrow consistent with the patient's history of sickle cell. There is inflammation in the soft tissues anterior medial. In addition there is: Increased signal on the T2-weighted images in the diaphysis. With the intravenous administration of gadolinium there is contrast enhancement in the proximal diaphysis and in the mid diaphysis. Between these 2 areas of enhancement there is a section of the diaphysis that does not enhance. This most likely represents osteomyelitis with central area of avascularity or necrosis.
Abnormal signal within the left tibia highly suspicious for osteomyelitis.