Male 65 years old Reason: osteomyelitis History: diabetic foot ulcer. Abnormal T1 hypointense signal within the metatarsal head of the great toe. There are also multilobulated foci of stir hyperintense signal within the subchondral metatarsal head which appear to demonstrate subtle enhancement. There is significant thickening of the soft tissue surrounding the first metatarsophalangeal joint . There is signal abnormality within the proximal and distal phalanx at the interphalangeal joint of the great toe however the pattern is suggestive of degenerative disease. Soft tissue irregularity overlying this interphalangeal joint likely corresponds to provided history of skin ulceration.There is enhancement and edema within the soft tissues of the foot suggestive of inflammation.
Abnormal signal intensity and enhancement within the first metatarsal head. The appearance may be secondary to patient's gout, in particular as this location is somewhat remote from the area of skin ulceration however in the context of this patient with diabetes and ulceration osteomyelitis cannot be completely excluded.