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Because a stress fracture is rare and easily missed on an x-ray, it might go undetected. If a patient presents with an activity related injury to the midfoot and x-rays are negative, a computed tomography scan can be helpful in diagnosing a cuboid stress fracture. Also, computed tomography scans graphically show the fracture location and size, in addition to tracking progressive bone changes during the healing process.
Unenhanced magnetic resonance imaging diagnoses osteonecrosis on the basis of loss of fatty marrow and the presence of edema. Enhanced magnetic resonance imaging, however, directly assesses marrow perfusion and allows earlier prediction of osteonecrosis after a bunionectomy.
The presence of subcutaneous nodules in association with rheumatoid arthritis is well documented. In most cases, these nodules occur in association with severe rheumatoid disease. Treatment should be initiated with conservative measures such as custom-molded shoes, nonweightbearing, and oral antibiotic therapy to control infection. The goals of surgery were to alleviate pain, improve function and cosmesis, remove infected bone, and prevent further infection. The surgical sites are completely healed without complications 2 years postoperatively.
