A 62-Year-Old Man Comes to the Office Due to Difficulty

A 62-year-old man comes to the office due to difficulty walking and mild pain in the left foot for the past several months.  He now ambulates with a cane and recently began using an old ankle brace for support.  The patient's medical history is significant for type 1 diabetes mellitus, hypertension, and hypercholesterolemia.  Physical examination shows a significantly deformed left ankle and a mildly deformed left foot.  X-ray of the left foot with weight bearing shows bone loss, large osteophytes, and several extraarticular bone fragments, as seen in the image below. Which of the following is the most likely cause of this patient's foot pain?

A) Avascular necrosis
B) Bacterial infection
C) Bone demineralization
D) Hyperuricemia
E) Nerve damage
F) Rheumatoid arthritis

Correct Answer:

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