DOI: https://doi.org/10.36347/sasjm.2025.v11i11.011

Pages: 1127-1129

Emphysematous osteomyelitis is a rare and aggressive form of bone infection in which gas-forming organisms produce air locules within the osseous structures. We report the case of a 66-year-old man with a history of diabetes and long-term smoking who presented with painful ulceration of the left foot and cutaneous tissue loss over several proximal phalanges. Imaging revealed intramedullary gas within the distal phalanx of the third toe, consistent with emphysematous osteomyelitis. Surgical exploration confirmed the presence of necrotic bone, and cultures grew Escherichia coli. This case highlights the importance of early recognition of gas within bone as an imaging hallmark of severe infection, particularly in high-risk patients.