Sepsis and bilateral lower extremity wound infections. Evaluate for osteomyelitis. Right:There is irregularity of the skin surface with shallow soft tissue defects affecting the mid and lower right leg consistent with ulceration. There is mild enhancement of the skin of the lower leg as well as reticulation of the subcutaneous fat indicating edema and inflammation. The edema becomes confluent within the posterior and lateral subcutaneous fat of the leg, but we see no rim-enhancing fluid collections to suggest abscess. There is mild edema between the medial head of the gastrocnemius and the underlying soleus as well as within the peroneal musculature, but we see no well-defined inter- or intramuscular fluid collections. Bone marrow signal intensity of the tibia and fibula is normal without evidence of osteomyelitis. Note is made of chronic periosteal reaction along the distal fibula.Left:There is mild enhancement of the skin as well as edema in the subcutaneous fat of the mid and lower left leg indicating inflammation. Although the edema becomes confluent particularly along the posterior aspect of the leg musculature we see no rim-enhancing fluid collections to indicate an abscess. We see no inter- or intramuscular fluid collection. There is a small intramedullary focus of abnormal signal intensity (low on T1-weighted images, high on T2 weighted images) again seen within the fibular head, showing minimal if any enhancement following contrast administration, which is nonspecific but could possibly reflect sequelae of prior infection; it is identical to the prior study. We otherwise see no signal abnormality within the tibia or fibula to indicate osteomyelitis.
Soft tissue inflammation consistent with cellulitis without evidence of acute osteomyelitis.