Reason: Osteomyelitis of the heel History: Ulceration There is soft tissue irregularity and ulceration along the plantar aspect of the calcaneus and cuboid which extends dorsally to the level of the calcaneocuboid articulation. There is increased signal abnormality within the lateral and plantar aspect of the calcaneus and cuboid on fluid sensitive sequences with associated decreased signal abnormality on T1-weighted images, situated about the calcaneocuboid articulation consistent with osteomyelitis, corresponding to findings seen on recent radiographs. There is a moderate sized joint effusion within Chopart's joint which appears to communicate with the aforementioned soft tissue ulceration which is concerning for a septic arthritis. There is a small amount of fluid within the tibiotalar and subtalar joints. There is extensive subcutaneous edema about the ankle and dorsal aspect of foot. There is increased signal abnormality within the plantar musculature of the foot which is nonspecific but can be seen in diabetic patients although myositis cannot be excluded. There is loss of the normal fat within the sinus tarsus which may be related to the aforementioned effusion. There are foci of increased signal abnormality within the talus, including the head neck and body, which may be degenerative in etiology. Note is made of postsurgical changes of prior intramedullary rod in screw fixation of the imaged portion of the distal tibia. There is fusion of the cuneiforms and first through third metatarsals.
Osteomyelitis of the calcaneus and cuboid as described above. Moderate sized joint effusion within Chopart's joint which appears to communicate with the plantar soft tissue ulceration, which is concerning for a septic arthritis. 