Back to Osteomyelitis 2

Osteomyelitis - MR

Case Images

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Case Notes

History

Second toe pain in a patient with diabetes.

Exam

Prior Study

Dicom

 

Findings

You scored: 0 / 21
Limitations Correct Answer Your Answer

There is patient motion or other limitations.

 Yes  NA
Skin/Hypodermis Correct Answer Your Answer

There is edema or hyperenhancement.

 Yes  NA

There is soft tissue ulceration or sinus tract.

No  NA

There is gas or foreign body.

 No  NA

There is confluent hypoenhancement to suggest phlegmon, suppuration, abscess, or drainable fluid collection in the hypodermis.

 No  NA
Investing/Intermuscular Fascia Correct Answer Your Answer

There is edema, thickening, or hyperenhancement.

No  NA

There is hypoenhancement or gas/susceptibility artifact.

 No  NA

There is bulging of the fascia.

 No  NA
Muscles Correct Answer Your Answer

There is edema or hyperenhancement.

No  NA

There is hypoenhancement, lack of enhancement, or organized fluid collection.

No  NA

There is fatty atrophy.

 No  NA
Bones Correct Answer Your Answer

There are fractures.

 No  NA

There is periosteal reaction, osseous destruction, or other abnormal marrow to suggest osteomyelitis.

 Yes  NA

There is osseous hypoenhancement or lack of enhancement to suggest loss of bone viability.

 No  NA

There is cloaca, sequestrum, or involucrum.

 No  NA

There is a subperiosteal or intra-osseous abscess.

 No  NA
Visualized Joints Correct Answer Your Answer

There is a joint effusion or synovitis.

 No  NA

There is malalignment, degenerative changes, or other gross internal derangement.

 Yes  NA
Miscellaneous Correct Answer Your Answer

There is tenosynovitis.

 No  NA

Major visualized vascular structures are abnormal.

 No  NA

Major visualized nerves are abnormal.

 No  NA

Impression

Expert Answer

Signal changes about the second toe proximal interphalangeal joint are nonspecific and could be related to a mechanical etiology such as stress reaction. Infection is an additional consideration, though thought less likely given lack of significant surrounding soft tissue edema.

Your Answer

Recommendations & Acuity

Recommendations

Expert Answer

Follow up as clinically indicated.

Your Answer

Acuity

Expert Answer

Routine Communication Permissable

Your Answer

View Reference Material
Section 1

Submit Findings

CB1134

Findings

Limitations

There is patient motion or other limitations.

Skin/Hypodermis

There is edema or hyperenhancement.

There is soft tissue ulceration or sinus tract.

There is gas or foreign body.

There is confluent hypoenhancement to suggest phlegmon, suppuration, abscess, or drainable fluid collection in the hypodermis.

Investing/Intermuscular Fascia

There is edema, thickening, or hyperenhancement.

There is hypoenhancement or gas/susceptibility artifact.

There is bulging of the fascia.

Muscles

There is edema or hyperenhancement.

There is hypoenhancement, lack of enhancement, or organized fluid collection.

There is fatty atrophy.

Bones

There are fractures.

There is periosteal reaction, osseous destruction, or other abnormal marrow to suggest osteomyelitis.

There is osseous hypoenhancement or lack of enhancement to suggest loss of bone viability.

There is cloaca, sequestrum, or involucrum.

There is a subperiosteal or intra-osseous abscess.

Visualized Joints

There is a joint effusion or synovitis.

There is malalignment, degenerative changes, or other gross internal derangement.

Miscellaneous

There is tenosynovitis.

Major visualized vascular structures are abnormal.

Major visualized nerves are abnormal.