Mycetoma presenting as a painful ankle monoarthropathy: A case report

Mycetoma or 'Madura foot' is uncommon in developed countries. We report a case of a 50-year-old man with chronic left ankle pain and swelling treated as a monoarthropathy under medical supervision for 2 years. He had an excisional biopsy and histopathology confirmed Madurella mycetomatis. Madura foot should be considered in the differential diagnosis of chronic painful joint swellings in susceptible individuals. MRI scan is a useful diagnostic tool but it may be missed if the features are atypical as emphasised in this case. Histopathology remains the mainstay of diagnosis and for planning effective treatment.