Reason: hx of DM with non healing wound of Lt index finger History: non healing wound and pain of left foot, toe has been discolored with a foul odor for 2 years Toe: There is soft tissue ulceration of the tip of the first toe. Mild irregularity of the tuft of the distal phalanx is suspicious for osteomyelitis. MRI may be obtained if further imaging is clinically warranted.Finger: There is mild soft tissue swelling of the index finger. There is mild irregularity of the cortical margin of the radial aspect of the base of the middle phalanx, which was present on prior exam dated 5/8/2014. This may represent additional site of prior infection but we suspect it is chronic. Mild osteoarthritis affects the index finger.
1. Ulceration of the left first toe with irregularity of the distal tuft is suspicious for osteomyelitis.2. Soft tissue swelling of the index finger and other findings as described above with no definite features of acute osteomyelitis.3. Further evaluation with MRI may be obtained if clinically warranted.