Emphysematous osteomyelitis of the calcaneus: a case report and review

Emphysematous osteomyelitis is a rare but potentially fatal condition, which classically features intraosseous air on imaging without a direct communication with the atmosphere. Prompt recognition and treatment of the disease cannot be overstated as there is a high mortality rate associated with this condition. Here we report a case of emphysematous osteomyelitis of the calcaneus in a sixty-one-year-old male with diabetes mellitus and end-stage renal disease. This case of osteomyelitis was associated with an overlying necrotizing soft tissue infection, mandating an urgent below-knee amputation for source control. This case report is the first of its kind in the literature involving the calcaneous as emphysematous osteomyelitis more commonly involves the vertebral column. The purpose of this case report is to discuss the presentation and treatment of emphysematous osteomyelitis involving the calcaneous as well as provide a review of the current literature on this diagnosis.