Male, 17 years old. Reason: h/o GSW to right foot with resultant cellulitis, concern for osteomyelitis History: pain, erythema, swelling, known fracture There is diffuse signal abnormality involving the first metatarsal, centered on the diaphysis, but extending to the proximal articular surface. There is decreased signal on T1 weighted imaging and increased signal on T2-weighted imaging, and there is significant associated circumferential cortical destruction through the length of the metatarsal. There is soft tissue edema/inflammation primarily involving the plantar soft tissues of the foot, and there is a sinus tract extending from the proximal first metatarsal diaphysis to the plantar soft tissues. These findings are compatible with osteomyelitis.The other imaged bones have normal marrow signal and intact cortical margins.
Findings compatible with osteomyelitis of the first metatarsal, with a sinus tract extending from the adjacent inflamed plantar soft tissues to the involved bone.