Diagnostic imaging of foot mycetomas: A report on two cases

Bentaleb, Daoud; Mahdar, Imane; Noureddine, Leila; Mellouki, Abdrrahmane; Sabiri, Mouna; Lembarki, Ghizlane; Essodegui, Fatiha; Regragui, Meriem

doi:10.1016/j.radcr.2022.02.081

Cited by 3 publications

(7 citation statements)

References 5 publications

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“…It predominantly involves the subcutaneous tissue but frequently in ltrates the muscles and deeper soft tissue due to its aggressive nature (13), as observed in our case. The presence of 'dot-in-circle' sign has been described as a speci c hallmark for pedal mycetoma (11)(12)(13)(14). It has been described in cases of both eumycetoma and actinomycetoma.…”

Section: Discussionmentioning

confidence: 99%

From a Radiologist’s Eye: a Case Report of Actinomycetoma of the Foot With Comprehensive Review of Literature

2024

Preprint

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Background: Tropical diseases comprise of an array of communicable and non-communicable diseases that prevail in the tropical belt. Madura foot, classified as a tropical disease by WHO, is a chronic granulomatous disease that predominantly involves the skin and subcutaneous tissue, commonly affecting the lower limbs. We present a case of actinomycetoma with extensive review of the existing literature, focusing on diagnostic imaging. Case presentation: A 36-year-old female from eastern India presented with a six-month history of right foot swelling and a discharging wound. She was unsuccessfully treated with multiple courses of antibiotics in local hospitals. Upon referral, radiological investigations were performed for further evaluation. USG showed infiltrative hypoechoic soft tissue with nodular lesions showing targetoid appearance. MRI revealed infiltrative soft tissue with variable sized nodular lesion showing characteristic ‘dot-in-circle' appearance, prompting the diagnosis of pedal mycetoma. Actinomycetoma was confirmed on biopsy. Conclusions: Pedal mycetoma presents significant diagnostic and therapeutic challenges owing to its insidious progression and delayed diagnosis. Radiological imaging, particularly MRI, plays a pivotal role in diagnosis and staging of the disease, enabling detailed evaluation of soft tissue and bone involvement. The ‘dot-in-circle' sign observed on imaging is pathognomic and aids in accurate diagnosis. Early diagnosis facilitated by diagnostic imaging warrants improved therapeutic outcomes.

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Section: Discussionmentioning

confidence: 99%

From a Radiologist’s Eye: a Case Report of Actinomycetoma of the Foot With Comprehensive Review of Literature

2024

Preprint

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“…It is described in MRI as conglomerates of small (2-5 mm) round hyperintense lesions, representing the granulation tissue, surrounded by low-signal-intensity rim, representing intervening fibrous septa. The central low-signal-intensity dot is the result of susceptibility effect caused by the presence of fungal grains [7] , [8] , [9] , [10] . In our case, we noticed the aforementioned characteristic dot in circle sign.…”

Section: Discussionmentioning

confidence: 99%

Dot in circle sign on MRI in foot mycetoma

Kashikar,

Madke

et al. 2024

Radiology Case Reports

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“…Tendon and nerve structures appear to be resistant until late in the disease course. When clinically suspected, the presence of the characteristic grains in histopathologic sections and culture of grains on specific media establish the diagnosis and allow definitive identification of the causative agent [3] , [9] . However, low clinical suspicion and difficulty identifying the causal agents with a biopsy or culture often lead to a delayed diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…However, low clinical suspicion and difficulty identifying the causal agents with a biopsy or culture often lead to a delayed diagnosis. Imaging is a fast and affordable diagnostic tool that can offer a non-invasive diagnosis and be used to evaluate the extent of the disease [9] .…”

Section: Discussionmentioning

confidence: 99%

“…Radiographs may be normal or show soft tissue swelling, bone sclerosis, bone cavities with a moth-eaten appearance, periosteal reaction, cortical scalloping, fanning of the rays, or osteoporosis [6] , [9] . Eumycotic lesions tend to form a few cavities in bone that are ≥ 1 cm in diameter, while actinomycetes often form smaller but more numerous cavities, leading to a moth-eaten appearance [7] .…”

Section: Discussionmentioning

confidence: 99%

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Madura foot and a continued diagnostic enigma: Dot-in-circle sign on magnetic resonance imaging and ultrasound

Hailemariam,

Tamiru,

Manyazewal

et al. 2023

IDCases

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Diagnostic imaging of foot mycetomas: A report on two cases

Cited by 3 publications

References 5 publications

From a Radiologist’s Eye: a Case Report of Actinomycetoma of the Foot With Comprehensive Review of Literature

From a Radiologist’s Eye: a Case Report of Actinomycetoma of the Foot With Comprehensive Review of Literature

Dot in circle sign on MRI in foot mycetoma

Madura foot and a continued diagnostic enigma: Dot-in-circle sign on magnetic resonance imaging and ultrasound

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