51 y/o male presents with pain and swelling of his right foo | Figure 1

Case Description

51 y/o male presents with pain and swelling of his right foot. Dropped an 18 V battery pack on his foot two months ago. CKD with dialysis. Not diabetic, but some diminished sensation. Self-employed carpenter. Metatarsal fractures are obvious, but I am concerned about the destruction of the first MTP joint. Diagnosed but not treated for psoriatic arthritis. No infection. Renal osteodystrophy?

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