Neuropathic Arthropathy

Red Arrows: Fragmentation of the metatarsal basesGreen Arrow: Widening of the Lisfranc joint commonly seen in neuropathic arthropathyYellow Arrow: Diffuse soft tissue swelling without ulcer

Neuropathic Arthropathy

Fragmentation of the metatarsal bases with destruction of the midfoot joints and associated effusion

Neuropathic Arthropathy

Diffuse soft tissue swelling without an ulcer. Constellation of findings (soft tissue swelling, no ulcer, joint disorganization and bone fragmentation) characteristic of neuropathic arthropathy.

Osteomyelitis

Yellow Arrow: Destruction of fifth metatarsal base with adjacent soft tissue ulcerGreen Arrow: Much less soft tissue swelling than neuropathy case

Osteomyelitis

Edema centered within the cuboid bone itself (vs. the joint-centered edema and destruction in the neuropathy case)

Osteomyelitis

Large soft tissue ulcer in continuity with cuboid bone marrow edema and destruction, diagnostic of osteomyelitis on MRI. In the radiology of diabetic feet, no ulcer=no osteomyelitis.