73-year-old male with worsening pain, edema, heat, s/p amputation (5/27/2015) left 2nd toe. There are postoperative findings related to first digit transmetatarsal amputation with interval amputation of the second digit through the tarsometatarsal joint. There is decreased T1 signal with corresponding increased T2 signal of the head of the second metatarsal. Similar intensity pattern affects the navicular bone as well as the partially imaged talus. These findings are compatible with osteomyelitis. There is marked soft tissue swelling along the dorsum of the foot with a complex fluid collection extending from the second metatarsal head proximally and laterally towards the ankle extending beyond the proximal margin of the image. The largest component of the fluid collection measures 5.3 cm x 2.5 cm.
Note that this is a limited study as described above. Within these limitations, the following observations are made: 1. Findings compatible with osteomyelitis of the 2nd metatarsal head as well as the navicular bone and partially imaged talus. 2. There is marked soft tissue swelling along the dorsum of the foot with a complex fluid collection extending from the second metatarsal head proximally and laterally towards the ankle extending beyond the proximal margin of the image. This may represent an abscess although evaluation of the fluid collection is limited due to lack of postcontrast sequences. 