23-year-old male with history of leukocytosis and recent fasciotomy. Evaluate for osteomyelitis. There are full-thickness defects of the subcutaneous fat along the medial and lateral aspects of the proximal and mid calf containing surgical drains compatible with stated history of recent fasciotomy. There is enhancement of the exposed surfaces of the musculature indicating inflammation as well as enhancement of the adjacent subcutaneous fat, predominantly anteriorly. There is also diffuse subcutaneous edema. There is marked, slightly heterogeneous enhancement of the soleus, tibialis posterior, inferior aspect of the popliteus, and lateral head of the gastrocnemius which is nonspecific and could reflect sequela of ischemia, inflammation, or infection (pyomyositis); however we see no discrete drainable fluid collection. There is relatively mild edema within the peroneal musculature and anterior musculature. There is a small focus of high T1/T2 signal abnormality within the anterior compartment which represents a small hematoma measuring 1 cm. There is intermuscular edema between the heads of the gastrocnemius musculature. The bone marrow signal intensity of the tibia and fibula is normal with no evidence of osteomyelitis.
1. Postoperative changes of medial and lateral fasciotomies with surgical drains present.2. Muscular enhancement as described above which is nonspecific and could reflect sequela of ischemia, inflammation, or infection (pyomyositis); however we see no discrete drainable fluid collection3. Additional soft tissue inflammatory changes as described above without evidence of osteomyelitis.