Osteomyelitis First ray: Normal marrow signal. A small lobulated tarsometatarsal joint focus of low T1/high STIR signal is identified at the and MTP joint which may reflect a small amount of joint fluid or cystic structure however this is incompletely characterized on this exam..Second ray: Normal marrow signal.Third ray: Normal marrow signal.Fourth ray: Normal marrow signal.Fifth ray: There has been amputation of the fifth ray to the level of the mid metatarsal diaphysis. Although there is soft tissue ulceration to the level of the surgical margins, the margins margins appear sharp and there is no definite evidence of residual osteomyelitis given the absence of discrete low T1 signal intensity. Increased STIR signal is noted within the remaining metaphysis which may be reactive in nature given the recent surgery. There is ill-defined heterogeneous signal intensity within the surgical bed containing areas of increased T1 signal. This may in part represent a postsurgical hematoma but absent intravenous contrast, it cannot be further characterized.There is mild diffuse subcutaneous edema particularly within the plantar soft tissues. Within the limits of this exam, there is no discrete fluid collection.
Surgical changes of fifth ray amputation to the level of the mid metatarsal diaphysis. There is no definite evidence of residual osteomyelitis but close follow-up is recommended.