Foot Osteomyelitis

57 year old diabetic male patient presents with chronic foot ulcer on right heel. He was septic and was started on broad spectrum antibiotics. Cultures grew multiple organisms including enteric gram negatives and anerobes. He was switched to IV ertapenem.

MRI of the foot is shown blow

Foot Osteomyelitis

Note the arrow pointing towards the bone which looks abnormal (different from other bones). These are changes of chronic extensive osteomyelitis.

The pt opted for medical management. He was discharged on 6 weeks of IV ertapenem.