Female, 91 years old. Reason: right ankle/heel wound eval for osteo History: ankle/heel wound Several sequences are limited by patient motion artifact. The patient refused further imaging, and no contrast-enhanced sequences were performed.Markers were placed along the posterior aspect of the heel and lower leg, presumably denoting the extent of the patient's wound. There is a soft tissue defect measuring at least 3 cm in diameter situated above the level of the calcaneus posteriorly and extending to the Achilles tendon. There is thickening and increased signal intensity of the underlying Achilles tendon, indicating tendinopathy, but we see no fluid collection to suggest soft tissue abscess.There is a second soft tissue defect posterior to the calcaneus that does not appear to extend to the bone. Minimal increased signal intensity within the posterior aspect of the calcaneus on fat suppressed T2W images (series 1001) likely represents osteitis rather than osteomyelitis as the signal intensity on T1W images appears relatively normal.Mild osteoarthritis affects the ankle and midfoot. There is a small amount of fluid in the subtalar joint which is not necessarily of any true clinical significance. We see no specific findings to suggest septic arthritis. There is moderate to severe fatty atrophy of the musculature of the ankle.There appears to be a focal longitudinal split tear of the peroneus brevis tendon as it courses beneath the fibular tip. The medial tendons and anterior tendons appear normal for age. Evaluation of the ligaments is limited on this study.
Soft tissue ulceration and other findings as above without findings to suggest osteomyelitis.