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Fig. 3D. —Pathologically proven osteomyelitis of fifth proximal phalanx in 60-year-old diabetic man with gangrene of fifth toe and distal lateral forefoot. Contrast-enhanced, fat-suppressed FMPSPGR MR image (250/2.1; flip angle, 90°) reveals nonenhancing tissue at lateral forefoot (arrows) that extends from ulcer around fifth proximal phalanx. No abnormal signal increase is seen in marrow of proximal phalanx. After MR imaging, partial fifth ray amputation was performed, with débridement of all necrotic tissue and resection of fifth metatarsal head.

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