Presentation
Diabetic foot ulcer with extensive ulceration. To exclude osteomyelitis.
Patient Data
Osteopenic bones likely due to Sudeks atrophy. Soft tissue edema.
Gas locules within the soft tissues posterior to the calcaneum either tracking from an open wound or soft tissue infection by a gas forming organism.
No underlying specific features of bone or joint infection.
55 days later.
Plantar foot ulcer probed to bone with osteomyelitis - starting ceftriaxone and oral metronidazole.
Generalized osteopenia in the midfoot.
The calcaneum is grossly abnormal with diffuse bony destruction. This has occurred since the prior radiograph 8 weeks ago.
Vertically oriented pathological fracture through the mid calcaneal body.
Case Discussion
The effects of osteomyelitis in a diabetic foot can be profound, rapid and life changing.
The calcaneal destruction here will result in substantial long term effects on the patient's activities of daily living (ADLs).
The end result for this patient was an amputation.