59 year-old female with right toe pain, evaluate for osteomyelitis Soft tissue Ulceration along the distal phalanx of the great toe with interval improvement in underlying marrow signal abnormality, now with mild residual edema. There is a new punched out lesion along the first metatarsal head with sclerotic margins and associated enhancement, which is likely chronic and may represent chronic infection or gout, correlate clinically. Mild degenerative changes affect the midfoot.
1. Soft tissue ulceration about the distal first phalanx with minimal underlying marrow edema, improved from the prior exam, now without specific evidence of osteomyelitis.2. New punched out sclerotic lesion involving the first metatarsal head which appears chronic and may be secondary to infection or gout, correlate clinically.