Osteomyelitis

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Poorly controlled diabetic. Previous amputation of great toe. New ulceration.

Patient Data

Age: 66
Gender: Female
x-ray

Great toe amputation at the level of the MTP joint.

Soft tissue swelling at the amputation site.

Extensive cortical destruction and lucency of the 1st metatarsal head and neck.

Periosteal reaction of the mid-shaft of the first metatarsal.

The remaining digits are normal.

Case Discussion

Diabetic patients are very prone to infections of all descriptions, including osteomyelitis.

Poor peripheral circulation contributing to the issue.

Amputations are not infrequent.  Even post amputation a further bout of osteomyelitis is not uncommon.

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