Reason: R/o osteomyelitis History: Relapsed AML, Persistent R ankle lesion, Neutropenic fever, Abnormal X-ray Note is made of soft tissue ulceration along the lateral aspect of the distal fibular metaphysis. There is a skin marker in the overlying area presumably corresponding to the patient's area of concern. There is subcutaneous edema type signal abnormality/inflammatory change in the surrounding area. There is no bone marrow signal abnormality in the surrounding area to suggest osteomyelitis. There is heterogeneous bone marrow signal which is nonspecific but may represent residual islands of red marrow versus a myeloproliferative disorder. There is subchondral cyst formation within the calcaneus about the calcaneocuboid articulation indicating degenerative change. The flexor and extensor tendons appear intact. There is circumferential fluid within the flexor hallucis longus tendon at the level of the master knot of Henry indicating a tenosynovitis, which can be seen in a tendon intersection syndrome. The Achilles tendon is normal in appearance. The peroneal tendons appear intact. The distal tibiofibular syndesmotic complex appears intact. The lateral collateral ligament complex appears intact. The imaged components of the deltoid appear intact. There is a small amount of fluid within the tibiotalar joint. There is a small subtalar joint effusion. There is no enhancing mass or fluid collection on postcontrast sequences.
1. Ulceration and subcutaneous edema/inflammatory change along the lateral aspect of the ankle without evidence of osteomyelitis. No focal fluid collection to suggest abscess formation.2. Findings indicating a tenosynovitis of the flexor hallucis longus just proximal to the level of the master knot of Henry as described above.3. Small subtalar joint effusion.4. Osteoarthritis of the ankle.