Presentation
Type 2 diabetic for 12 years, referred with great toe ulcer.
Patient Data
Extensive bone marrow signal changes (T1 hypointense, T2 and PD hyperintense) is seen involving the greate toe distal phalanx.
A sinus tract is seen from the great toe distal phalanx tuft to the skin along the distal medial surface.
Edema and fluid signal intensity also are seen within greate toe subcutaneous tissues.
Minimal joint effusion is seen at the first metatarsophalangeal joint.
Subchondral edematous changes also are seen at the first metatarsal head in the plantar aspect.
Case Discussion
Regarding the imaging findings, great toe distal phalanx osteomyelitis is the main diagnoses.