0:00

Okay, so I, I'd like to wrap, uh, to wrap it up with the,

0:05

with the fourth case.

0:07

And this fourth case is just to,

0:11

to show some classy findings of the charco, the charco foot.

0:16

And here we can see, uh, uh,

0:19

this is a 4 40, 3 40 2-year-old female

0:23

with diabetic malitus.

0:25

And we can see this, uh, fragmentation, this

0:30

destructions, this, the destruction

0:33

of the bonds of the midfoot.

0:35

And this is the class key findings

0:39

of the charco foot, right?

0:41

What happens here a lot is this cys, uh, changes

0:46

that we can see in this patient.

0:47

So this is a finding

0:49

that it talks more about charco foot than an infection.

0:53

And another thing that, uh, we have to be sure about

0:56

that there is no infection, is the T one image right here.

1:00

We can see this is the two,

1:02

the two T two image here is the T one image.

1:05

We can see all this, uh, destruction of the bones of the,

1:09

uh, midfoot with the cystic changes at the midfoot.

1:13

Uh, and here, there is a,

1:16

there is already an ulcer right here.

1:19

There's a ulcer here,

1:21

but on the two, one, uh, the bone marrow is preserved.

1:25

Okay? The, there is no osteomyelitis yet in this patient.

1:30

Probably it will evolve to osteomyelitis, uh,

1:34

if not treated well.

1:35

But at this time, if, uh, the doctors, uh, ask me is the,

1:40

this patient has osteomyelitis or not?

1:44

No, no, it is not osteomyelitis.

1:46

The ulcer is, is close to the bone,

1:48

but the, the, the bone, the,

1:51

the signal is preserved in T one.

1:54

Um, just to finish this case, I'd like

1:57

to show this very classy appearance of the charcoal foot.

2:02

That is the rocker bottom foot.

2:04

So that's the appearance of the rocker.

2:06

Bottom foot, when you, there is an inversion of the normal,

2:11

uh, longitudinal arc of the foot.

2:14

Instead of being, uh, uh, convex, it's concave.

2:18

Okay? So, or in, instead of concave, it's convex. Okay?

2:23

So that is what I'd like to show, uh, for you

2:28

and this forest part of the course today.