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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.

Original publication

DOI

10.1007/s00256-002-0600-2

Type

Journal article

Journal

Skeletal radiology

Publication Date

03/2003

Volume

32

Pages

179 - 183

Addresses

Medical School, University of Oxford, Oxford, UK.

Keywords

OSIRIS collaborative study group, Humans, Foot Diseases, Magnetic Resonance Imaging, Ultrasonography, Aged, Middle Aged, Male, Mycetoma