Radiologist's view on Pedal Actinomycetoma

A Case Report with Comprehensive Review of Literature

Authors

  • Mohan Venugopal Dept. Radiodiagnosis, Sri Narayani Hospital & Research Centre, Sripuram, Vellore-632055, Tamil Nadu, India
  • Ebinesh Arulnathan Lincoln County Hospital, United Lincolnshire Teaching Hospitals NHS Trust, Lincolnshire- LN2 5QY, UK https://orcid.org/0000-0001-8778-9902 (unauthenticated)
  • Bhuvanamha Devi Dept. Pathology, Sri Narayani Hospital & Research Centre, Sripuram, Vellore- 632055, Tamil Nadu, India
  • Poonkodi Manohar Dept. Pathology, Sri Narayani Hospital & Research Centre, Sripuram, Vellore- 632055, Tamil Nadu, India
  • Praislin Gideon Meenakshi Mission Hospital & Research Centre, Madurai, Tamil Nadu, India

DOI:

https://doi.org/10.59667/sjoranm.v21i1.26

Keywords:

Pedal mycetoma, Madura foot, Actinomycetoma, Dot-in-circle sign

Abstract

Background: Tropical diseases include communicable and non-communicable diseases prevalent in tropical regions. Mycetoma is a chronic granulomatous infection involving the skin and subcutaneous tissue, commonly affecting the lower limbs. We present a case of actinomycetoma and a narrative review of the literature, focusing on diagnostic imaging.

Case presentation: A 36-year-old woman from eastern India presented with a six-month history of right foot swelling and a discharging wound. Multiple courses of antibiotics had been unsuccessful. Ultrasonography showed infiltrative hypoechoic soft tissue with nodular targetoid lesions. MRI demonstrated multiple nodular lesions with the characteristic dot-in-circle appearance, suggesting pedal mycetoma. Biopsy confirmed actinomycetoma.

Conclusion: Pedal mycetoma presents diagnostic and therapeutic challenges because of its insidious progression and delayed diagnosis. MRI helps assess soft tissue and bone involvement and disease extent. The dot-in-circle sign is characteristic and highly suggestive of mycetoma, but diagnosis requires histopathological and/or microbiological confirmation. Early recognition may improve treatment outcomes.

Author Biographies

  • Mohan Venugopal, Dept. Radiodiagnosis, Sri Narayani Hospital & Research Centre, Sripuram, Vellore-632055, Tamil Nadu, India
    1. Head and Senior Consultant, Department of Radiodiagnosis, Sri Narayani Hospital & Research Centre, Sripuram, Vellore- 632055, Tamil Nadu, Email: mohu97@gmail.com
  • Ebinesh Arulnathan, Lincoln County Hospital, United Lincolnshire Teaching Hospitals NHS Trust, Lincolnshire- LN2 5QY, UK

    MBBS, MD, MICR, DNB, FRCR, EDiR, DICR, Consultant Radiologist, Department of Radiology, Lincoln County Hospital, United Lincolnshire Teaching Hospitals NHS Trust, Lincolnshire- LN2 5QY, United Kingdom

  • Bhuvanamha Devi, Dept. Pathology, Sri Narayani Hospital & Research Centre, Sripuram, Vellore- 632055, Tamil Nadu, India
    1. Consultant, Department of Pathology, Sri Narayani Hospital & Research Centre, Sripuram, Vellore- 632055, Tamil Nadu, Email: drbdevipath@gmail.com 
  • Poonkodi Manohar, Dept. Pathology, Sri Narayani Hospital & Research Centre, Sripuram, Vellore- 632055, Tamil Nadu, India

    Consultant, Department of Pathology, Sri Narayani Hospital & Research Centre, Sripuram, Vellore- 632055, Tamil Nadu, India. Email: drpoonkodimohan@gmail.com 

  • Praislin Gideon, Meenakshi Mission Hospital & Research Centre, Madurai, Tamil Nadu, India

     Medical Officer, Meenakshi Mission Hospital & Research Centre, Madurai, Tamil Nadu, India. Email: praislinpraisy@gmail.com

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SJORANM article cover, Vol. 21 No. 1 (2025). Holographic symbolic illustration for article 74.

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Published

2025-07-31

Data Availability Statement

This article presents a clinical case and a narrative review of published literature. The case information and cited literature underpinning the report are described in the article.

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Vol. 21 No. 1 (2025)

Section

Case reports

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Copyright (c) 2025 Mohan Venugopal, Ebinesh Arulnathan, Bhuvanamha Devi, Poonkodi Manohar, Praislin Gideon

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How to Cite

Venugopal, M., Arulnathan, E., Devi, B. ., Manohar, P. ., & Gideon, P. . (2025). Radiologist’s view on Pedal Actinomycetoma: A Case Report with Comprehensive Review of Literature. Swiss Journal of Radiology and Nuclear Medicine, 21(1), 36-50. https://doi.org/10.59667/sjoranm.v21i1.26

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