Osteomyelitis

Bone irregularity

First toe distal phalanx tuft lytic changes and fragmentation compatible with osteomyelitis, in accord to medical history.

Wound opening

Soft tissue loss and air at the tip of the first toe corresponding to the wound opening.

Amputation

Previous amputation of the middle and distal phalanges of the second toe, likely following a previous osteomyelitis: the loss of sensation seen in paraplegia (as well as in the diabetic neuropathy) makes these patients at high risk for open wound and infection of the feet. A residual bony fragment can be seen.