METATARSAL HEAD - Chronic osteomyelitis

The specimen is a metatarsal head showing, on one side, an irregular cavity involving both bone and cartilage with some irregular lipping at the margin. A small bony sequestrum can be seen in the centre of the cavity.
This 20 year old woman presented with episodes of pain and swelling about the second metatarsal head of the right foot. Some 6 months before, she had suffered a laceration of the sole of the right foot. An X-ray (which accompanies the specimen) showed rarefaction of the metatarsal head; Penicillin resistant Staphylococcus aureus was recovered. The lesion settled initially but some months later recurred and the metatarsal head was excised.