Fig. 6.

A 60-year-old man presented with a chronic ulcer on the lateral aspect of the right heel, with symptoms of infection. Axial (a) T1-W, (b) T2-W FS and (c) STIR MR images of the right foot show an ulcer (white arrows) along the lateral aspect of the heel with surrounding cellulitis (arrowheads). Low T1-W and high T2-W marrow signals in the adjacent calcaneum, with associated cortical ill-definition, suggest osteomyelitis (asterisks). Notice also the reactive myositis involving the interosseous muscles, seen as high signal on T2-W FS and STIR sequences (black arrows). High T2-W signal in the visualised proximal phalanges on the T2-W FS image (b) is due to failure of fat suppression (thin arrows), a potential pitfall in MR imaging. The corresponding areas on the STIR sequence (c) show better fat suppression, with appropriate signal drop-out of normal marrow (broken arrows).