Reason: Osteomyelitis of the tibia? History: Erythema and purulence from anterior tibial lesion. Outside bone scan suggestive of osteomyelitis There is a small focus of abnormal signal intensity and enhancement within the skin and subcutaneous fat anterior to the tibial tubercle that presumably represents the site of prior intervention/lancing. There is thickening and mild enhancement of the adjacent skin as well as mild enhancement of the subcutaneous fat perhaps representing a cellulitis which extends laterally along the anterior and lateral compartment musculature. We see no inter or intramuscular fluid collection or enhancement. There is minimal increased signal intensity on fluid sensitive sequences and enhancement of the tibial tubercle with relative preservation of bone marrow signal intensity on T1-weighted images and no frank cortical destruction. These findings likely represent reactive osteitis rather than osteomyelitis. There is a small amount of fluid within the knee joint but no large effusion is evident. There are small cysts seen within the intercondylar eminence of the proximal tibia of doubtful current clinical significance.
Superficial soft tissue inflammation as described above with findings suggestive of mild reactive osteitis rather than osteomyelitis of the tibial tubercle