Reason: patient w/ ulcer on left great toe, elevated inflammatory markers, eval for osteomyelitis. History: toe ulceration Evaluation is limited due to patient motion artifact. There appears to be bandage material along the medial aspect of the forefoot. There is abnormal signal intensity within the medial soft tissues of the forefoot extending to the great toe and also extending along the dorsal and plantar aspect of the first MTP joint, likely reflecting a combination of edema and scar tissue. This has perhaps progressed slightly beneath the first MTP joint, with what appears to be additional soft tissue ulceration. There is a chronic appearing erosion along the medial aspect of the first metatarsal head that was present on the prior MRI examination and is nonspecific. There is a bipartite medial sesamoid bone, but we see no imaging features to suggest acute osteomyelitis. There is a hallux valgus deformity with osteoarthritis of the first MTP joint and interphalangeal joint of the great toe. We see no fluid collection to suggest abscess formation. There is atrophy of the musculature of the foot.
Limited evaluation due to patient motion artifact. Soft tissue ulceration and subcutaneous signal changes likely reflecting a combination of inflammation and scarring with chronic erosion of the first metatarsal head, but no findings to suggest acute osteomyelitis. Other findings as described above.