Type 2 diabetes, nonhealing ulcer. MR evaluation demonstrates marked signal abnormality and questionable cortical bone loss involving the distal tuft of the first right toe. Plain film correlation would be helpful for confirmation, however cortical margins are not well visualized and underlying enhancement is observed. Underlying subungual soft tissue and/or possible pus with surrounding inflammation and no clear ulceration. There are visualized second toe and remaining visualized digits are otherwise unremarkable. More proximally proximal phalanx and metatarsals are also unremarkable. Alignment preserved throughout.
Suspected multiple changes compatible with osteomyelitis of the tuft of the first toe. Plain film correlation would be helpful