Presentation
Type 2 diabetic from 20 years ago referred with great toe ulcer.
Patient Data
Age: 65 years
Gender: Female
From the case:
Osteomyelitis - great toe
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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:
- the 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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