Her legs look swollen with haemoserous weeping on the anterior aspects of her shins. There is also surrounding erythema and the entire lower legs, bilaterally, are exquisitely painful. Distally she is neurovascularly intact and there is no clinical concern of a lower leg compartment syndrome.
X-rays were requested given the unusual presentation and broad list of differentials:
There is bilateral pretibial soft tissue swelling and generalised subcut oedema
There is extensive bone destruction/resportion and reparation with periostitis involving the anterolateral margin of both tibias R > L
These are centred on the midshaft
This is all consistent with osteomylitis.
She needs to switch the myrtle for the PICC & enjoy.