Wednesday, January 4, 2006

Podiatry Source Journal : Foot Ulcers

Foot Ulcers
A 31-year-old man from northern Ontario had acute swelling, purpura and pain in his left lateral forefoot region, which increased progressively over 10 weeks until he became bedridden. A clinical diagnosis of gout was made, but the pain did not improve with NSAIDs. One month later, a small pustule developed that progressed to an ulcer with purulent drainage. On presentation 1 month later, his left foot was swollen, and the lateral forefoot was exquisitely tender to palpation. A 2-cm ulcer, which probed to bone, was present on the lateral aspect of the foot (Fig. 1). The patient was afebrile, and findings on general medical and pulmonary examinations were unremarkable. A plain radiograph of the foot revealed dystrophic calcification in the soft tissues, with osteopenia and periosteal reaction along the fifth metatarsal bone consistent with active osteomyelitis (Fig. 2). The chest radiograph appeared normal.