64-year-old male with history of ulnar osteomyelitis present with increased pain and swelling of the right wrist. Again seen is a lytic lesion of the distal ulna that is centered in the metaphysis and extends to the articular surface. A smaller lytic lesion present more proximally was seen on the prior radiograph from 10/27/2015, but is new compared to radiograph from 5/12/2015. Also again seen is cortical disruption and periosteal reaction along the ulnar aspect of the distal ulna with small lucencies in a permeative appearance extending to the mid-diaphysis, in a similar distribution as seen on the prior MRI. Soft tissue swelling is again noted. No definite radiographic evidence for osteomyelitis of the carpals or metacarpals to correspond to findings on MRI. No acute fractures are identified. Catheter is seen overlying the radius.
Osteomyelitis of the distal ulna progressed since 5/12/2015 examination, but not significantly changed since 10/27/2015 examination.