Fig. 1.

A 59-year-old woman presented with a left ankle ulcer with signs of infection. Coronal (a) T2-W fat-suppressed (FS) and (b) contrast-enhanced T1-W FS MR images of the left ankle show external markers (white arrows), indicating the site of an ulcer along the medial aspect of the distal tibia, evident as a soft tissue defect with focal interruption of the cutaneous line and elevated margins from pre-existing callus formation. High T2-W signal and contrast enhancement at the base of this ulcer are due to granulation tissue. Sagittal (c) T1-W, (d) T2-W FS and (e) contrast-enhanced T1-W FS MR images of the left foot show a focal fluid collection with high T2-W and low T1-W signals in the subcutaneous plane of the heel at the insertion of the Achilles tendon, typical of an adventitial bursa (black arrows). In this case, peripheral enhancement suggests superimposed inflammation/infection. Surrounding cellulitis is present at the dorsum of the foot, seen as areas of T1-hypointense and T2-hyperintense signals within the subcutaneous tissues with enhancement of subcutaneous fat (arrowheads).