59-year-old female with cellulitis and left great toe ulceration. Evaluate for osteomyelitis. Skin ulceration is noted along the dorsal aspect of the great toe. Surrounding the great toe is a large area of devitalized tissue with interspersed pockets of fluid measuring approximately 2.2 x 1.9 cm in greatest dimensions (series 1101, image 10). These findings extend from the distal tuft of the great toe along the flexor tendon to the level of the tarsometatarsal joint.Foci of low T1 and bright T2 signal involving the bone marrow of the distal tuft of the great toe are suggestive of distal osteomyelitis. There is diffuse subcutaneous edema as well as moderate osteoarthritis involving the first MTP joint.
1.Findings compatible with osteomyelitis of the distal tuft of the great toe as described above.2.Large area of devitalized tissue and interspersed fluid surrounding the great toe and extending proximally along the flexor and extensor tendon.