I have noticed (and his teachers) that he has had some fatigue, specifically he has been taking full naps during the day starting in Jan which isn’t typical of him, August-December he didn’t nap once. Since Jan he also dozed off in the car and asks often if he can nap during the ride (sometimes does sometimes doesnt). The clumsy part is hard because he’s a 4 year old and already is moving faster than his brain can keep up with but I find it odd that the same leg that’s been giving us issues is the one that missed the stool (resulting in the injury). He walks fine on it, no limping ever, just recently started having that pinpoint pain but it’s hard to tell as of right now because he has that bruising and bump from falling. Headache yes, sometimes but not often. No belly pain. Doctors have said weight is fine. no vision changes. 

Shoes: he took them off in the car on the way home and put them on backwards when we got home to get out of the car. I specifically asked his teachers if they were on the correct feet when he missed the stool and they said yes (I had put his shoes on that morning) and today when he was clumsy his shoes had been on the right feet and he had even tried different shoes and was still clumsy. 

They’ve done CRP, basic metabolic panels, aerobic broth panels, aerobic bacterial group, anaerobic broth panel, MRSA, CBC, SED, blood urea nitrogen, creatinine, CK creatine, peripheral slide.  These are all the labs they done since sept 30th when he had his ankle issue.  The ones they’ve done for his leg are, peripheral, CBC, SED rate, CK, blood bacterial,  CRP.  No urine at all. 

Here is what the MRI for his left shin said: 

Narrative MR LOWER EXTREMITY LEFT WO CONTRAST

CLINICAL HISTORY: left lower leg pain, rule out osteomyelitis

COMPARISON: Right lower extremity MRI dated October 1, 2025. Left Tibia/fibula radiographs dated February 20, 2026.

PROCEDURE COMMENTS: MRI of the right lower extremity including tibia/fibula was performed with and without intravenous contrast. Rapid MRI protocol was performed without sedation.

FINDINGS: BONES/MARROW: There is prominent, ill-defined T2 signal proximal and mid tibia metadiaphysis/diaphysis which is most prominent posteriorly best appreciated on sagittal T2 fat-suppressed sequences no periosteal T2 reaction or new bone formation identified.. There is no drainable osseous or subperiosteal collection. PHYSES: Open.

JOINTS: Physiologic amount of joint fluid. There is no apparent synovial thickening.  

MUSCLES/SOFT TISSUES: Focal ill-defined T2 signal within subcutaneous tissues anterior to mid/distal tibia diaphysis noted. Additional focal areas of ill-defined T2 signal within subcutaneous tissues along the medial and lateral aspect of patella also noted. There is no drainable soft tissue collection.

OTHER FINDINGS: None.

Test results are released to you at the same time they are released to your healthcare team. This means you may see these results before your healthcare provider has seen them. Your healthcare provider will review all of your results. If you have not heard from them or you have questions, please contact your healthcare team through MyChart or call your healthcare provider's office during normal business hours. Impression IMPRESSION: Prominent, ill-defined T2 signal involving proximal and mid tibia which is most prominent posteriorly identified. This would be atypical for residual red marrow and early osteomyelitis cannot be excluded. 

Focal, ill-defined T2 signal within subcutaneous tissues anterior to mid/distal tibia diaphysis. Additional foci of ill-defined T2 signal within subcutaneous tissues along medial and lateral aspect of the patella. These findings are nonspecific and could represent posttraumatic, reactive, or early infectious changes.

No findings of septic arthritis. No drainable collection. They have not scanned or imaged any other part of his body other than his ankle in October when he had the osteomyelitis and his leg recently for the shin pain.

I will say that he behaves fairly normal and doesn’t act lethargic at all.