Squamous Cell Carcinoma 5th Digit Foot

55-year-old male with a history of a chronic soft tissue ulceration over the right foot fifth digit. There is prominent T1 hypointense signal extending from the skin surface through the subcutaneous fat and into the medullary cavity of the proximal and distal phalanges of the fifth digit. There is preservation of the cortical margins of the head of the fifth metacarpal. Within the medullary cavity of the proximal and distal phalanges of the fifth digit, there is corresponding STIR hyperintense signal with heterogeneous enhancement extending from the skin surface to the medullary cavity. While osteomyelitis secondary to the chronic skin ulceration was considered, an infiltrated squamous cell carcinoma was also included on the differential given the lack of soft tissue tract and osseous erosions. The fifth digit was amputated, and a final pathologic diagnosis of invasive squamous cell carcinoma secondary to chronic inflammation was given.