What is the most likely diagnosis?

A 50-year-old woman noticed some swelling of her right great toe and a painful right foot. She had type 1 diabetes mellitus of 21 years’ duration and recent screening had revealed some mild diabetic retinal changes and peripheral neuropathy.

On examination, she had a hot, red right forefoot with swelling of the great toe. There was callus on the first metatarsal head with a blister beneath it. After de-roofing, the podiatrist probed to a depth of 1 cm. The left foot demonstrated reduced sensation to a 10-g monofilament. Her right foot was 0.6°C hotter than the left.

What is the most likely diagnosis?
A . Charcot’s foot
B . gout
C . necrotising fasciitis
D . osteoarthritis
E . osteomyelitis

View Answer

Answer: E