A 35 year old man came with swelling and pain in the left foot since two months.
AP and lateral radiographs of the left foot show a soft tissue swelling involving the midfoot and forefoot. Multiple osteolytic lesions of varying sizes are seen in the tarsal bones and bases of the metatarsals. The lesions show poorly defined margins with cortical destruction. Joint spaces of the midfoot appear distorted due to surrounding destructive changes. The MRI of the left ankle and foot shows multiple conglomerates of rounded lesions in the plantar and dorsal aspect of the foot along the tarsals and metatarsals. There are PDFS hyperintense collections with sinus tract formation and osteolytic destruction of the tarsals and metatarsals with marrow edema.