Osteomyelitis, shin, MR
Claim CME CreditPOINT OF CARE INFORMATION
This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CB1141-Osteomyelitis, shin, MR
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CB1141-Osteomyelitis, shin, MR
Case ReportHistory
Exam
Findings
Findings
Marrow destroying process in the mid to distal tibia. There is extensive marrow hypoenhancement with surrounding irregular hyperenhancement, consistent with large intraosseous abscess and surrounding osteomyelitis. The abscess extends over a craniocaudal dimension of approximately 16 cm. Marrow enhancement begins approximately 0.9 cm proximal to the tibial plafond. There are internal layering fat globules within the abscess. There are multiple defects within the tibial cortex, noted anteromedially on series 15 image 26 and noted posterolaterally on series 15 image is 23-27. T2 intermediate intensity material, reflecting inflammatory material, extends through the defects and uplifts the overlying periosteum. Aggressive appearing periosteal reaction is noted elsewhere.
Enhancing edema in the hypodermis along the anterior and medial aspects of the mid to distal calf. Edema in the muscles surrounding the marrow destroying process in the right tibia. No evidence for drainable fluid collection in the soft tissues.
Focal T2 intermediate intensity structure in the anterolateral aspect of the talar dome with subtle irregularity of the overlying articular cortex, corresponding to a hypoattenuating area on prior CT and lucency on prior radiograph. This is favored to reflect sequela of prior mechanical injury over additional infectious process, particularly given lack of joint effusion.
Impression
Signal abnormality in the anterolateral talar dome favored to reflect sequela of remote injury.
