Clinics in diagnostic imaging (26). Madura foot (or mycetoma)

A 40-year-old African man presented with a painful swollen right foot, with a plantar discharging sinus. Radiographs showed punched-out erosions of the metatarsals with surrounding sclerosis, consistent with Madura foot or mycetoma. The pathogenesis and radiological features of this entity are reviewed. Treatment is effective but the diagnosis is often considered late in the disease at the time of biopsy. Radiologists working in endemic regions must consider this condition in the differential diagnosis of chronic osteitis.