53 year old female. History of PVD and DM2, right calcaneal osteomyelitis. ? progression of disease. Right ankle: Again seen is a small ulcer in the soft tissues of the heel with underlying soft tissue signal abnormality that is T1 intermediate and heterogeneously T2 hyperintense consistent with fluid and scar tissue. Mild decrease in the amount of fluid signal extending along the medial and lateral aspects of the calcaneus. Focal erosion of the inferior posterior calcaneal body with slight interval decrease in confluent edema, consistent with osteomyelitis.Interval resolution of previously seen signal abnormality in the fibular tip as well as adjacent small collection. Chronic infarction of the distal tibia, unchanged. Right foot: There is a deep plantar ulcer in the forefoot going down to the 2nd metatarsal head. The 2nd MTP joint is dislocated with the 2nd metatarsal head directed inferiorly into the plantar soft tissues. There is confluent signal abnormality (T1 hypointense and T2 hyperintense) in the 2nd metatarsal epiphysis and proximal diaphysis consistent with osteomyelitis. Postsurgical findings of distal fifth metatarsal amputation. Diffuse subcutaneous edema.
1. Right calcaneus osteomyelitis is slightly decreased in extent. Previously seen osteomyelitis of the fibular tip has resolved.2. Deep plantar soft tissue ulcer going down to the 2nd metatarsal head, which has signal abnormality consistent with osteomyelitis. Dislocation of the 2nd MTP joint.