Figure 6.

A 16-year-old female who stepped on a wooden splinter 2 months earlier, now presents with right foot pain and purulent discharge from the puncture wound. (A) The dorso-plantar radiograph shows sclerosis of the 2nd and 3rd metatarsals, with surrounding periosteal reaction (black arrowheads). The wooden splinter is radiolucent; (B) coronal STIR image shows high signal in the medulla of the 3rd metatarsal (white arrow), consistent with bone marrow oedema; (C) axial STIR image shows that the splinter (black arrow) has become embedded in the 2nd intermetatarsal space. It is surrounded by a high signal fluid collection (white arrowheads) which communicates via a sinus tract (black arrowhead) to the skin surface; (D) axial STIR image at a more distal level showing bone marrow oedema (white arrow), periosteal elevation (white arrowheads) and a sinus tract extending from the bone to the skin surface (black arrow).