Reason: evaluate for osteomyelitis History: pain, redness and swelling Note is made of postsurgical changes of transmetatarsal amputation. There are foci of susceptibility artifact along the distal aspect of the metatarsal remnants likely postsurgical in etiology. Severe osteoarthritis affects the tibiotalar joint with full-thickness articular cartilage degeneration and subchondral signal abnormality, also likely degenerative in etiology. Otherwise no bone marrow signal abnormality to suggest osteomyelitis. Note is made of subcutaneous edema along the dorsal aspect of the fourth and fifth metatarsal remnants which enhances on postcontrast sequences likely representing a cellulitis. The visualized tendons appear intact. The distal tibiofibular syndesmotic complex appears intact. The ATFL is poorly visualized and likely disrupted. The PTFL and calcaneofibular ligaments appear intact. There is loss of the normal fatty striation of the image components of the deltoid ligament likely representing degeneration or prior injury. There is increased signal abnormality within the plantar musculature which is nonspecific but can be seen in diabetic patients. No focal fluid collection is identified to suggest abscess formation.
Postsurgical changes of the foot with osteoarthritis of the ankle. Findings suggestive of a mild cellulitis without findings to suggest osteomyelitis. No focal fluid collection is identified to suggest abscess formation. Other findings as described above.