62-year-old female with chronic lateral plantar heel callus. Evaluate lateral plantar heel callus for foreign body. A vitamin E capsule overlies plantar soft tissues underlying the calcaneus presumably representing the site of the patient's palpable abnormality. There is skin thickening in the area underlying the aforementioned marker. There is irregularity of the pad fat of the heel which extends to the superficial fascial plane. There is also a punctate focus of decreased signal abnormality within the skin surface about the superior aspect of the aforementioned marker. These findings are equivocal for a small foreign body. No large foreign body is identified. If further evaluation is clinically warranted, ultrasound examination could be considered. There is no focal fluid collection to suggest abscess formation. There is no susceptibility artifact to suggest a metallic foreign body. There are no inflammatory changed identified in the surrounding area. The flexor and extensor tendons appear intact. The peroneal tendons appear intact. The Achilles tendon is normal in appearance. The lateral collateral ligament complex appears intact. The distal tibiofibular syndesmotic complex appears intact. The imaged portions of the deltoid ligament appear intact. There is increased signal abnormality fourth tarsometatarsal joint, likely degenerative in etiology. There is associated subchondral cyst formation. There is a small amount of fluid within the tibiotalar joint without evidence of a large effusion. There is mild increased signal abnormality within the medial aspect of the talar dome, likely degenerative in etiology. No osteochondral defect is identified. There is a trace amount of fluid within the retrocalcaneal bursa.
Equivocal tiny foreign body within the superficial soft tissues of the heel as described above. If there is strong clinical concern for a retained foreign body, further evaluation with a dedicated ultrasound examination could be considered. 