Inflammation, check for osteomyelitis with left foot ulcer A moderate deep ulcer is noted under the ball of the foot as well as diffuse irregularities to the soft tissues of involving the more medial aspects and first digit. Severe degenerative and demineralization limits sensitivity creating mildly irregular cortical margins, specifically involving the base of the first proximal phalanx and head of the first metatarsal. No definite destruction and primary changes of osteomyelitis, however in light of the history and ulceration, concern remains. Follow-up serial imaging and/or possibly 3 phase bone scanning or MRI can be considered.The remainder of the second through fifth digits again demonstrate scattered more moderate degenerative changes more mild abnormalities in the midfoot and hindfoot. Mild to moderate arterial vascular disease. Diffuse additional soft tissue changes that may represent mild cellulitis.
Marked limitations with nonspecific findings involving the first digit with an underlying moderately deep plantar ulceration. Close serial imaging and/or possibly 3 phase bone or scanning should be considered, if suspicion remains high and for confirmation.