Male, 67 years old. Left lower extremity pain. There is soft tissue edema about the forefoot, with skin irregularity overlying the distal aspect of the second proximal phalanx. No discrete fluid collection is identified.There is cortical thinning/irregularity of the head of the proximal phalanx of the second toe with associated marrow signal abnormality on both T1 and T2-weighted images, compatible with osteomyelitis. There is also marrow edema within the distal phalanx of the great toe, and the cortex is slightly indistinct, raising suspicion for osteomyelitis. The other visualized osseous structures have normal signal characteristics.
Osteomyelitis of the proximal phalanx of the second toe and findings suspicious for additional focus of osteomyelitis of the distal phalanx of the great toe.