Fevers and leukocytosis There has been amputation of the great toe through the proximal phalanx and of the second toe through the head of the proximal phalanx.There is ulceration of the soft tissues along the medial plantar aspect of the great toe with a fluid signal intensity tract extending to the base of the remaining proximal phalanx. There is enhancement of the soft tissue around the sinus tract indicating inflammation although no discrete focal collection is identified. On T1-weighted images, there is focal intermediate signal intensity within the base of the proximal phalanx at the site of the sinus tract with enhancement of the marrow following contrast administration. There is diffuse edema of the bone on the T2 fat sat sequences. The constellation of these findings strongly suggests osteomyelitis. The remaining marrow of the first metatarsal, sesamoid bones, and phalanges is otherwise normal. There is mild osteoarthritis of the midfoot.There is atrophy of the musculature with mild edema along the dorsal soft tissues.
Soft tissue ulceration with associated osteomyelitis of the proximal phalanx of the great toe.