Foot #2 - Answers

1. Osteomyelitis of the left great toe (organism unknown)
2. Septic arthritis of the left 1st IP joint

Findings

1. Marked destruction of both bones of the left great toe on both sides of a joint
2. Loss of the subchondral line of the distal phalanx
3. Marked soft tissue swelling

Brief Discussion

The soft tissue swelling here is not terribly specific, but is strongly suggestive of some type of inflammatory process. The fact that the process involves both sides of a joint and the joint between should firmly steer us toward a diagnosis of infection. The loss of the subchondral line is another strong clue toward a septic case for this destructive lesion. Although the organism is unknown in this case, the smart money is on staphylococcus aureus.

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