Great toe osteomyelitis and Sudeck atrophy of foot

Case contributed by Shahmeer Khan
Diagnosis almost certain

Presentation

History of prior stroke and feeling of excessive warmth along with diffuse pain in left foot since 3 months now presented to orthopedic clinical with swelling of left great toe for 1 week.

Patient Data

Age: 70 years
Gender: Male

Destruction of both phalanges of the big toe of the left foot.

There is swelling of the overlying soft tissues with a few foci of air.

Appearances are consistent with osteomyelitis of the great toe.

Marked periarticular osteopenia involving the visualized bones, joint spaces are maintained.

Case Discussion

Patient had long standing history of immobilization secondary to prior stroke.

In view of his clinical history of feeling excessive warmth and pain radiographic features are consistent with sudeck atrophy, while the x ray findings of great toe are consistent with osteomyelitis. 

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