Female 46 years old Reason: R medial foot pain near peak of arch. Type I DM for years. Assess for Charcot changes, rule out stress fracture History: Foot pain There is mild osteoarthritic changes with subchondral cysts at the tibiotalar joint. Along the dorsal aspect of the talonavicular articulation there is osseous debris; multiple small ossific fragments dorsally (series 7, image 15), better seen on radiographs 6/10/2016. Abnormal low T1 signal on the anterior aspect of the navicular bone where it articulates with the cuneiforms. This abnormal signal is on both sides of the joint. There is abnormal low T1 signal and high T2 signal throughout the middle cuneiform. Subchondral cyst and abnormal T2 hyperintensity is present in the lateral cuboid where articulates with the fourth and fifth metatarsal tarsals. At the junction of the base and diaphysis of the fifth and third metatarsal there is abnormal high T2 and low T1 signal which marrow edema, possibly secondary to stress reaction. No fracture lines are identified. No large joint effusion.The tendons are normal in appearance.
Multiple areas of abnormal marrow signal as well as osseous debris suggestive of early Charcot foot as detailed above. 