Madura Foot: MRI

Case Report - A 45 year non-diabetic male pt. presents with pain& swelling in right foot  of about 2-3 months duration for MRI foot with clinical suspicion of actinomycetoma.Radiological Findings1.   4THMetatarsal shows cortical thickening and sclerosis in shaft& mild expansile lytic lesions in the base with ill defined T2 hypointense soft tissue around the base. Multiple lytic lesions also seen in talus (neck and anterior body), anterior calcaneum, inferior cuboid, intermediate& lateral cuneiforms.2.   Ill defined T2 hypointense soft tissue seen in the subcutaneous plane of mid foot sole& in the dorsum of foot  over the head of  1st& 2ndmetatarsal showing small rounded areas with faint iso to hyperintense signal with hypointense rim& central tiny dot like hypointense focus – suggesting dot-in-circle sign.3.   Ill defined T2 hypointense soft tissue also seen in the superficial& deep muscle planes of the plantar aspect of mid& hind foot with similar signal pattern.Findings are suggestive of chronic osteomyelitis of foot due to granulomatous etiology most likely due to actinomycetoma, consistent with history. Differential – TB ( less likely).Teaching Points by Dr MGK Murthy, Dr GA Prasad1.   Mycetoma or Madura foot is a chronic granulomatous infection of the dermis and epidermis caused by the bacteria Actinomyces (Actinomycetoma) or by true fun...
Source: Sumer's Radiology Site - Category: Radiology Authors: Source Type: blogs