Subperiosteal Abscess (32, 37)

Left Image: Longitudinal sonogram of the leg shows a soft tissue process (yellow shade/arrow) along the periosteal surface of the tibial cortex (red line/arrow).

Right Image: Power Doppler imaging reveals markedly increased flow in this region indicating inflammation.

Left and Right Images: Transverse sonograms of the tibia again shows the periosteal  complex hypoechoic lesion consistent with subperiosteal abscess (yellow shade/arrow).  Note the tibial cortex (red line/arrow).
Left Image: Longitudinal sonogram shows the subperiosteal abscess (yellow shade/arrow) extending along the tibial cortex (red line/arrow) to the physeal plate (blue arrows).