Diagnosis is by biopsy, visualising the fungi under the microscope and culture, which show characteristic fungal filaments and vesicles characteristic of the fungi. Other tests include ELISA, immunodiffusion, and PCR with DNA sequencing (so-called DNA barcoding). X rays and ultrasonography may be carried out to assess the extent of the disease. X rays findings are extremely variable. The disease is most often observed at an advanced stage that exhibits extensive destruction of all bones of the foot. Rarely, a single lesion may be seen in the tibia where the picture is identical with chronic osteomyelitis. Cytology of fine needle aspirate or pus from the lesion, and tissue biopsy may be undertaken sometimes. Some publications have claimed a "dot in a circle sign" as a characteristic MRI feature for this condition (this feature has also been described on ultrasound). Madura Foot X-Ray Differential diagnosis The following clinical conditions may be considered before diagnosing a patient with mycetoma: # Tuberculous ulcer # Kaposi's sarcoma, a vascular tumour of skin usually seen in AIDS. # Leprosy # Syphilis # Malignant neoplasm # Tropical ulcer # Botryomycosis, a skin infection usually caused by the bacteria Staphylococcus aureus.
Eumycetoma
Mycetoma
Littoral cell angioma
Adenoacanthoma
Hamartoma
Nesidioblastoma
Neural fibrolipoma
Esthesioneuroblastoma