case_images: PMC10539787_01
case_images: Timeline of patient history.
case_images: jbji-8-183-f01.jpg
case_images: PMC10539787_01_jbji-8-183-f01.jpg
case_images: Ch1.F1
case_images: In 1989 he reported that the skin overlying the site of injury broke down, for which he underwent debridement and skin grafting (Fig. 1).
case_images: Clinical photographs of ulcer along with radiographs and MRI
  imaging from corresponding time points.
case_images: jbji-8-183-f02.jpg
case_images: PMC10539787_01_jbji-8-183-f02.jpg
case_images: Ch1.F2
case_images: At first presentation to our unit, he had a large ulcer overlying the medial face of the tibia with underlying chronic osteomyelitis (Fig. 2a). He underwent an MRI scan (Fig. 2b), ultrasound duplex scan, and vascular review. In December 2021, it was noted that he had developed an exophytic lesion at the margin of his ulcer along with increasing malodour and discharge (Fig. 2c). His ulcer had grown (Fig. 2d), with ongoing malodour and discharge. As can be seen from the clinical photographs (Fig. 2), the ulcer appeared largely unchanged between 2003 and 2018. This had eroded the cortex and was confluent with the medulla of the tibia with extensive endosteal scalloping (Fig. 2).
case_images: Anterior-posterior radiographs from 2003-2023.
case_images: jbji-8-183-f03.jpg
case_images: PMC10539787_01_jbji-8-183-f03.jpg
case_images: Ch1.F3
case_images: This has instead been replaced by multiple lytic areas, separated by bony septa, spanning approximately 10 cm of the tibia (Figs. 3 and 4).
case_images: Anterior-posterior and lateral radiographs from 2003, 2020, and
  2023.
case_images: jbji-8-183-f04.jpg
case_images: PMC10539787_01_jbji-8-183-f04.jpg
case_images: Ch1.F4
case_images: This has instead been replaced by multiple lytic areas, separated by bony septa, spanning approximately 10 cm of the tibia (Figs. 3 and 4).