Diabetic Foot with Gas-Forming Infection

Andrew F. Barnes

Daniel B. Nissman

CLINICAL HISTORY

53-year-old male with history of type 2 diabetes mellitus presents with a non-healing ulcer on the plantar surface of his right foot at the base of the great toe. He also complains of fevers and diffuse erythema of the right foot.

FIGURE 100A

FIGURE 100B

FIGURE 100C

FINDINGS

AP and oblique radiographs of the right foot (Figs. 100A and 100B) demonstrate soft tissue edema and subcutaneous gas in the soft tissues about the first metatarsophalangeal (MTP) joint, which also tracks along the first and second metatarsals. The oblique view demonstrates a soft tissue defect subjacent to the first MTP joint. Axial CT of the right foot (Fig. 100C) at the level of the metatarsal heads reveals soft tissue gas about the first MTP joint with an associated superficial cutaneous defect.

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