Male 50 years old Reason: osteo History: drainage, xray suspicious Postsurgical findings of fourth and fifth transmetatarsal amputations. A large soft tissue defect/ulcer with surrounding inflammation extends along the lateral foot overlying the metatarsals. There is no rim enhancing focus to suggest abscess. The inflammation extends to the subjacent fourth and fifth metatarsal bones which demonstrate cortical irregularity as well as abnormal T1 hypointense/STIR hyperintense signal and enhancement consistent with osteomyelitis. The third metatarsal demonstrates stir hyperintense signal throughout the body without convincing enhancement or T1 hypointense signal and this may represent edema rather than frank osteomyelitis. There is marked edema within the superficial and deep subcutaneous tissues as well as the muscles of the foot. There is abnormal STIR hyperintense signal at the tarsometatarsal joints which is likely degenerative.
Osteomyelitis involving the amputated fourth and fifth metatarsals which underlies deep skin ulceration.