case_images: PMC10866038_01
case_images: An essentially normal lateral radiograph of the foot demonstrating normal morphology of the talus with no evidence of osteomyelitis, periosteal reaction or evidence of a lytic lesion.
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case_images: PMC10866038_01_acmi-6-707.v3-g001.jpg
case_images: F1
case_images: The X-rays were essentially normal (Fig. 1).
case_images: A T2 weighted MRI of the talus. 1) loss of cortical continuity and 2) increased signal in the talus indicating marrow oedema.
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case_images: PMC10866038_01_acmi-6-707.v3-g002.jpg
case_images: F2
case_images: The MRI of her left ankle demonstrated a large joint effusion and a disruption in the cortical outline of the talus in the postero-inferior subtalar facet with surrounding marrow oedema (Fig. 2).
case_images: An intra-operative radiograph showing the position of the curette within the sub-talar space.
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case_images: PMC10866038_01_acmi-6-707.v3-g003.jpg
case_images: F3
case_images: The decision was taken to proceed with drilling and curettage of the talus and washout of the subtalar joint (Fig. 3) with autologous bone grafting.
case_images: A timeline of events.
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case_images: PMC10866038_01_acmi-6-707.v3-g004.jpg
case_images: F4
case_images: The patient improved after both the operation and course of antibiotics (Fig. 4).
case_images: Satisfactory lateral radiograph of the talus showing no signs of osteomyelitis and good bony alignment.
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case_images: PMC10866038_01_acmi-6-707.v3-g005.jpg
case_images: F5
case_images: Two weeks post-operatively she was reviewed and found to be asymptomatic, her wounds had healed sufficiently, she had a good range of motion in her ankle, normal bloods and a normal X-ray (Fig. 5).
case_images: Repeat T2 weight sequence MRI showing resolution of marrow oedema. Cavity left by curettage and filled with bone graft.
case_images: acmi-6-707.v3-g006.jpg
case_images: PMC10866038_01_acmi-6-707.v3-g006.jpg
case_images: F6
case_images: She is still under follow up 9 months post-op with no recurrence of her symptoms and a repeat MRI confirmed complete resolution of infection (Fig. 6).