Osteomyelitis in diabetic foot

Case contributed by Bálint Botz
Diagnosis almost certain

Presentation

Diabetes, fever of unknown origin, markedly elevated inflammatory markers, painful, localized hyperemic area around the medial aspect of the right ankle.

Patient Data

Age: 45 years
Gender: Female
x-ray

Circumscribed loss of well-defined cortical contours (see key image) can be observed at the medial aspect of the talus, corresponding to the affected area. (Courtesy of Dr. Péter Klespitz)

ultrasound

US demonstrated an inhomogenously echogenic area in the soft tissues surrounding the localized cortical bone destruction with markedly increased vascularity. 

Case Discussion

The X-ray and US findings together with the clinical picture are in line with circumscribed osteomyelitis of diabetic origin with surrounding soft tissue involvement.

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