Bilateral Charcot joints with Lisfranc injuries
Review in clinic
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Degenerative and erosive changes in the midfoot, disruption of the Lisfranc ligament, rocker-bottom deformity and 3rd-5th claw toes. There is new lucency in the base of the 1st metatarsal (best seen on the oblique view) suggestive of osteomyelitis compared to the previous radiographs from 9 months prior. Small bony fragments superior to the talar head and medial to the calcaneus represents bony debris. Soft tissue swelling and a locule of subcutaneous gas on the dorsum of the foot.
Lateral subluxation of the tarsometatarsal joints has slightly progressed. Claw 2nd to 5th toes.