77-year-old male with soft tissue infection of the right foot, ulceration of the right first toe and elevated CRP. Evaluate for osteomyelitis. There is increased bone marrow signal abnormality on fluid sensitive sequences within the distal phalanx of the great toe which is associated with decreased bone marrow signal abnormality on T1-weighted images. There is increased signal abnormality on fluid sensitive sequences within the soft tissues along the dorsal aspect of the IP joint/nailbed of the great toe which extends from the skin surface to the level of the distal phalanx, consistent with the stated history of ulceration. There is diffuse increased signal abnormality within the plantar musculature of the midfoot which enhances on post contrast sequences may represent inflammatory changes related to infection, although no definite fluid collection is identified to suggest abscess formation.
Findings consistent with osteomyelitis of the distal phalanx of the great toe. Other findings as described above.