Eumycetoma Osteomyelitis of the Calcaneus in a Child: A Radiologic-Pathologic Correlation following Total Calcanectomy

Figure 3

(a) Intraoperative images of superior surface of calcaneus employing the heel splitting approach. Note the extensive conglomerates of black grains scattered over that surface (solid arrows). Note the complete destruction of the articular cartilage of the posterior facet of the subtalar joint (hollow arrows). (b) Operative images of superior surface of calcaneus following total resection, employing the heel splitting approach. Note the extensive conglomerates of black grains scattered over that surface (white solid arrows) and the articular cartilage erosions of the anterior and middle facets of the subtalar joint (hollow white arrows). Complete destruction of the articular cartilage of the posterior facet of the subtalar joint with gross deformation is depicted (hollow black arrow). (c) Operative images of inferior surface of the calcaneus following total resection, employing the heel splitting approach. Note the presence of multiple bony cavities of various sizes (white arrows). Foci of black granular discharge are depicted (hollow arrows). (d) Brown fungal colonies with surrounding inflammatory cells and fibrosis (H and E, 400).

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