Sore on foot for three days. Painful, foul smell, appears that wound may be deep. Evaluate for osteomyelitis. There is diffuse soft tissue swelling. There is ulceration of the plantar soft tissues beneath the calcaneus. I see no osteolysis of the calcaneus to indicate osteomyelitis. The Achilles tendon is indistinct, likely due to surrounding soft tissue swelling. Poorly defined lucency with sclerotic margins in the posterior aspect of the calcaneus may represent a cyst at the Achilles tendon insertion. There are small posterior and plantar calcaneal spurs. Arterial calcifications are noted within the soft tissues of the ankle.On the AP view, the medial margin of the fifth metatarsal is indistinct. I suspect that this is artifactual; however if there is strong clinical concern for osteomyelitis at this location, then MRI may be considered for further evaluation.
Soft tissue swelling and other findings as above without definite radiographic features of osteomyelitis. If there is strong clinical concern for osteomyelitis, MRI may be considered for further evaluation.