67-year-old male with a history of foreign body between the third and fourth metatarsals, on prior MRI dated 5/2013, which was not removed. Now with recent onset of increasing pain and edema. Again seen is a 1.6 cm linear focus of low signal abnormality along the dorsal aspect of the interspace between the third and fourth metatarsal heads, best seen on the sagittal STIR images (image 11; series 8), consistent with the patient's history of a retained foreign body. There is interval increase in size of the surrounding enhancing increased signal abnormality in the surrounding area along the dorsal aspect of the foot which extends into the web space between the third and fourth metatarsal, which may represent granulation tissue, measuring approximately 2.2 x 1.5 x 2.9 cm (image 27; series 4). There is a central focus of fluid signal intensity which does not enhance on post contrast sequences which may represent fluid/debris within a subcentimeter abscess (image 27; series 10). There is extensive subcutaneous edema in the surrounding area along the dorsal aspect of the second through fifth metatarsals.There is increased T2 signal abnormality in the bone marrow of the proximal phalanx of the fourth digit of the left foot without associated decreased T1 signal abnormality likely representing reactive osteitis. Osteomyelitis is considered less likely. There is also fluid along the tendon sheath of the extensor digitorum tendon of the fourth digit of the left foot which is suspicious for tenosynovitis.
Retained foreign body along the dorsal aspect of the third and fourth metatarsals with interval increase in the previously described surrounding inflammatory change and equivocal subcentimeter abscess formation.