Reason: r/o osteomyelitis, extent of infection to wound in foot History: purulent drainage with foul odor several months There is minimal soft tissue irregularity along the plantar aspect of the base of the proximal phalanx of the great toe consistent with the stated history of ulceration. There is increased signal abnormality within the surrounding subcutaneous and soft tissues which demonstrates enhancement on postcontrast sequences likely representing a cellulitis in the correct clinical context. There is minimal increased signal abnormality and fluid sensitive sequences within the proximal phalanx and to a greater extent the distal phalanx of the great toe. There is no corresponding decreased signal abnormality on T1-weighted images to confirm osteomyelitis. These findings are most consistent with reactive osteitis. There is increased signal abnormality on fluid sensitive sequences within the plantar musculature of the foot which is nonspecific but can be seen in myositis. Minimal degenerative changes affect the tarsometatarsal joints. The flexor and extensor tendons appear intact. There is no focal fluid collection to suggest abscess formation. There is no frank osteolysis to suggest osteomyelitis.
Soft tissue ulceration along the plantar aspect of the great toe with findings suggestive of a cellulitis as described above. Bone marrow signal abnormality within the proximal and distal phalanx of the great toe in a pattern most consistent with reactive osteitis. There are no findings to suggest osteomyelitis. No focal fluid collection is identified to suggest abscess formation. Other findings as described above.