71-year-old female. Left heel ulcer. Evaluate for osteomyelitis extent in the calcaneus. There is ulceration of the soft tissues plantar to the posterior aspect of the calcaneus. The soft tissues between the ulcer and the calcaneus are replaced with abnormal signal intensity. There is also abnormal signal intensity in the inferior aspect of the posterior calcaneal tuberosity that is T1 intermediate signal intensity and T2 high signal intensity indicating osteomyelitis. The anterior aspect and superior aspect of the calcaneal body appear spared. The remaining visualized bones appear normal. We see no fluid collection in the soft tissues to suggest an abscess. Prominent enthesophyte at the insertion of the Achilles tendon on the calcaneus. The Achilles tendon itself and the remaining tendons of the ankle are unremarkable. There is thickening of the skin along the medial and lateral aspects of the ankle with mild edema in the underlying subcutaneous fat. Osteoarthritic changes affect the hindfoot and the ankle. There is atrophy of the plantar muscles of the foot.
Soft tissue ulcer and calcaneus osteomyelitis, as above.