Right foot ulcer There is abnormal low T1 signal with corresponding high T2 signal and enhancement of the distal portion of the fifth proximal phalanx and the proximal portion of the fifth middle phalanx consistent with osteomyelitis. No additional areas of focal osteomyelitis are identified. Abnormal T1 and T2 signal is also noted within the anterior portion of the distal tibia (series 9 images 11-13) but there is no bony erosion or overlying skin defect to suggest osteomyelitis in this is likely reactive or degenerative in nature.There is no evidence of focal fluid collection/abscess. There is diffuse soft tissue enhancement/inflammation surrounding the lateral portion of the foot both within the plantar and dorsal soft tissues. There is no evidence of a joint effusion within the fifth PIP joint to suggest septic arthritis. Diffuse increased signal is also noted within the plantar musculature which also may be reactive given the patient's history of a muscular dystrophy.
Osteomyelitis about the fifth PIP joint as detailed above. There is no evidence of abscess or joint effusion within the PIP joint. If surgical intervention is being considered, repeat MRI for confirmation should also be considered.