Osteomyelitis - great toe

Case contributed by Dr Bahman Rasuli

Presentation

Type 2 diabetic from 20 years ago referred with great toe ulcer.

Patient Data

Age: 65 years
Gender: Female
MRI

Extensive bone marrow signal changes (T1 hypointense, T2 and PD hyperintense) is seen involving the big toe proximal and distal phalanges. 

A sinus tract is seen from the big toe proximal phalanx head into the skin in the medial aspect.

Edema and fluid signal intensity also are seen within the forefoot intrinsic muscles and subcutaneous tissues.

Case Discussion

Diabetes mellitus can involve the foot by two mechanisms:

  • First one is osteomyelitis which mainly affects the pressure points in the forefoot and hindfoot.
  • The second one is a neuropathic joint which affects the intertarsal joints causing joint destruction disorganization and dislocation.
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Case information

rID: 68942
Published: 1st Jul 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Jame Jam Imaging Center

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