Osteomyelitis, shin, ankle, CT
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.
CB1140-Osteomyelitis, shin, ankle, CT
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CB1140-Osteomyelitis, shin, ankle, CT
Case ReportHistory
Exam
Findings
Findings
Marrow destroying process beginning approximately 1 cm proximal to the tibial plafond and extending proximally within the tibial medullary cavity off the field-of-view, at least 16 cm proximal to the tibial plafond. The medullary destruction is primarily isoattenuating to adjacent muscle. There are internal areas of low attenuation, with internal layering fat globules, concerning for intraosseous abscess. There is medullary bone which is separated from the adjacent bone, suggesting sequestrum. There are defects within the cortical bone. Soft tissue density extends through these defects and uplifts the overlying periosteum. Periosteal reaction is noted elsewhere.
There is surrounding soft tissue edema in the hypodermis of the anterior and medial calf. This extends down to the investing fascia. No thickening of the intramuscular fascia. No soft tissue drainable fluid collection. No subcutaneous gas visualized.
Presence of the fat globules, intraosseous fluid collection, extensive surrounding soft tissue edema, and clinical presentation favors a hematogenous infectious process over neoplasm.
Focal hypoattenuation along the anterolateral aspect of the talar dome with overlying articular surface irregularity. This demonstrate a chronic appearance and is likely from prior mechanical injury.
Impression
Chronic appearing osseous lesion in the anterolateral talar dome, likely reflecting prior mechanical injury.
