Female, 34 years old. SLE, dermatomyositis, reactive arthritis. Now with R ankle ulcer with cellulitis. There is ulceration of the skin and subcutaneous fat lateral to the distal fibula with inflammation of the adjacent soft tissues. However, we see no well-defined or rim-enhancing fluid collection to indicate an abscess. The inflammation extends to the peroneal musculature, but the peroneal muscles and tendons appear intact, as do the remaining tendons. We see no marrow signal abnormality to indicate osteomyelitis. Additional edema and mild diffuse enhancement is noted within the medial subcutaneous fat of the ankle as well as along the dorsum of the ankle. A small amount of fluid is noted in the tibiotalar, talonavicular, and subtalar joints, not necessarily of any clinical significance. The visualized ligaments are within normal limits. There is a small amount of fluid at the knot of Henry, also of doubtful clinical significance.
Soft tissue ulceration and inflammation without osteomyelitis.