Suppurative tenosynovitis and osteomyelitis

Case contributed by Ahmed Abdrabou
Diagnosis almost certain

Presentation

Pus discharge from the lateral aspect of the ankle is of long duration.

Patient Data

Age: 50 years
Gender: Male
This study is a stack
Axial
T1
This study is a stack
Axial
T2
This study is a stack
Coronal
T1
This study is a stack
Coronal
T2
This study is a stack
Coronal
STIR
This study is a stack
Sagittal
T1
This study is a stack
Sagittal
T2
This study is a stack
Sagittal
T1 C+
This study is a stack
Coronal
T1 C+
This study is a stack
Axial
T1 C+
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Info

Extensive inflammation centered on the peroneus longus and brevis tendons is associated with synovial hypertrophy and enhancement with medial extension to involve the distal fibula and lateral aspect of the calcaneus, resulting in osteomyelitis. The inflammation extends posteriorly to the Achilles tendon and involves the skin and subcutaneous tissue of the lateral aspect of the ankle, showing a sinus tract.

Case Discussion

Suppurative tenosynovitis of peroneal tendons and osteomyelitis. Given the imaging findings and chronicity, TB should be considered.

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