Madhura mycosis of foot

 

Sagittal T2w

Sagittal T1w

Sagittal STIR

MRI study of ankle/foot with x-ray correlation shows:

A lobulated abnormal soft tissue measuring approximately 70 mm in length and 40 mm in depth on dorsal aspect of foot encasing extensor tendons with hypo intense signal on T2-weighted images, “dot in a circle” sign on MRI. 

Soft tissue density on x-ray without dystrophic calcification on x-ray. Lytic destruction of adjacent anterior corner of tibia on MRI and x-ray. Associated tibio talar joint effusion. Multifocal ovoid lytic lesion with sclerotic rim on x-ray involving distal end of tibia with fluid signal on MRI. Marginal lytic destruction of distal end of fibula. Circumferential punched-out marginal erosion of neck of talus which is markedly thinned out with an associated marrow oedema on STIR. Multifocal marrow oedema involving tarsal bones, tenosynovitis of extensor as well as plantar tendons.

Multiple ulcers, nodules and discharging sinuses on skin of dorsal aspect of foot when examined clinically.

Imaging diagnosis: Madhura mycosis of foot with osteomyelitis of tibia.