Unusual presentation of calcaneal osteomyelitis. Twenty-five years after inoculation.

An unusual presentation of calcaneal osteomyelitis is described, where-by the infection remained undiagnosed for 25 years. The 36-year-old patient recently sought medical treatment for a reported ankle sprain, but the pain was recalcitrant to conservative care. Further investigation yielded a history significant for stepping on a chicken bone as a child, which entered the inferior lateral heel. Magnetic resonance imaging revealed what plain radiographs did not: a well demarcated lytic lesion in the body of the calcaneus. Intraoperative findings were consistent with an abscess of chronic osteomyelitis. The treatment included incision and drainage, antibiotic beads, and a tricortical bone graft.