Male 83 years old Reason: r/o osteonecrosis History: left lateral foot ulcer; h/o diabetes The patient has undergone resection of the fifth ray through the fifth metatarsal diaphysis. There is a small focus of heterotopic ossification seen in the soft tissues distal to the remaining fifth metatarsal. There is ulceration of the lateral soft tissues just distal to the remaining fifth metatarsal. There is adjacent low T1 signal suggesting scarring. We see no abnormality of the bone marrow to indicate osteomyelitis. There is also scarring of the subcutaneous fat adjacent to the base of the fifth metatarsal.Patient also has amputation of the second toe and distal phalanx of the first toe. Mild deformity of the head of the second metatarsal, but we see no features of osteomyelitis. Mild osteoarthritis affects the first metatarsophalangeal joint. Mild to moderate osteoarthritis affects the midfoot. Small collection of fluid within the flexor hallux longus tendon sheath at the knot of Henry may represent a focal tenosynovitis, but is not necessarily of any clinical significance.
Soft tissue ulcer and other findings as above, but we see no evidence of osteomyelitis.