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MRI of mycetoma of the foot: two cases demonstrating the dot-in-circle sign

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Abstract

Radiological and histological findings of two patients with fungal mycetoma of the foot are presented. MRI revealed multiple 2–5 mm lesions of high signal intensity interspersed within a low-intensity matrix. Within many of the lesions a minute low-intensity focus was identified. Ultrasound showed distinct hyperechoic foci within a hypoechoic mass. We speculate that the low-signal matrix represents fibrous tissue, the high-intensity lesions correspond to granulomata and the central low-signal focus to the characteristic organised fungal elements (grains) present in this condition. This "dot-in-circle sign" on MRI reflects the unique pathological features of mycetoma and is likely to be a highly specific sign for this lesion.

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Authors and Affiliations

  1. Medical School, University of Oxford, Oxford, UK

    I. Sarris

  2. Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford, UK

    A. R. Berendt

  3. Department of Pathology, Nuffield Department of Orthopaedic Surgery, University of Oxford, Oxford, UK

    N. Athanasous

  4. Department of Radiology, Nuffield Orthopaedic Centre, Oxford, OX3 7LD, UK

    S. J. Ostlere

Authors
  1. I. Sarris
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  2. A. R. Berendt
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  3. N. Athanasous
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  4. S. J. Ostlere
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Corresponding author

Correspondence to S. J. Ostlere.

Additional information

Published on behalf of the OSIRIS collaborative study group. Members of the OSIRIS collaborative study group involved in the management of the patients: N. Athanasous, B. Atkins, A.R. Berendt, I. Byren, P. Cooke, M. Gibbons and S.J. Ostlere

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Sarris, I., Berendt, A.R., Athanasous, N. et al. MRI of mycetoma of the foot: two cases demonstrating the dot-in-circle sign. Skeletal Radiol 32, 179–183 (2003). https://doi.org/10.1007/s00256-002-0600-2

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  • DOI: https://doi.org/10.1007/s00256-002-0600-2

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