Reason: Rule out osteomyelitis History: pain swelling Right toe:There is a focus of gas density overlying the tuft of the distal phalanx on the AP and oblique views which we suspect reflects air trapped between the upper toenail bed but we cannot entirely exclude focal bone erosion. If there is strong clinical concern for osteomyelitis, MRI could be obtained. Mild osteoarthritis affects the first MTP joint. Arterial vascular calcifications are noted.Left toe:There is irregularity of the soft tissues dorsal to the distal phalanx but we see no frank osteolysis to confirm osteomyelitis. Mild osteoarthritis affects the first MTP joint. Arterial vascular calcifications are noted.
1. Focus of gas density overlying the tuft of the distal phalanx of the right great toe. While we suspect this represents air trapped between the toenail bed, we cannot entirely exclude focal bone erosion. If there is strong clinical concern for osteomyelitis, MRI could be obtained.2. Soft tissue irregularity of the soft tissues dorsal to the distal phalanx of the left great toe without specific radiographic evidence of osteomyelitis.