Age / Sex : 65 / M

Chief complaint : Lt. lower extremity pain

Past Hx: 7세때 osteomyelitis로 수술받은 기왕력 +


What is your diagnosis?

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer)

Courtesy :  이슬기 (Seul Ki Lee), 성빈센트병원 (St. Vincent’s Hospital)

Majolin’s ulcer (squamous cell ca. arising in sites of long-standing chronic wounds or scars)

Discussion

Findings
Deformed contour, irregular low SI portion in lateral eccentrical bone marrow in distal metadiaphysis of femur
Focal cortical defect, adhesion of surrounding muscle fascia with thickening
Fcal skin fistula and segmentally irregular thickening with enhancement, probable segmental periostitis.
--> correlation with plain radiograph, chronic osteomyelitis with Marjolin's ulcer

References
Imaging of a Marjolin's Ulcer: A Case Report; J Korean Soc Radiol. 2011 Jun;64(6):593-598.