Osteomyelitis of the 5th metatarsal head

Case contributed by Assoc Prof Craig Hacking

Presentation

2 months of 5th toe pain. Diabetic.

Patient Data

Age: 85 years
Gender: Male

Focal bone loss of the plantar aspect of the head of the 5th metatarsal. The 5th MTP joint appears intact. Extensive vascular calcification. Features in keeping with osteomyelitis. The adjacent soft tissues are thickened and there is a overlying dressing suggesting an ulcer as the cause.

Case Discussion

X-ray findings of osteomyelitis are usually only evident after 7-10 days.

The patient went on to have an amputation after failing medical therapy, and histology and MCS confirmed S. aureus osteomyelitis.

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