Madura foot masquerading as a hemangioma

Mycetoma, also known as Madura foot, is a rare soft-tissue granulomatous infection caused by Actinomyces or true fungi. The MRI “dot-in-circle” sign has been described as a characteristic finding of mycetoma. This sign represents spherical T2 bright masses containing central and intervening low-signal-intensity foci. However, other soft-tissue masses can have similar appearances. We present a case of a Madura foot that was erroneously given the imaging diagnosis of soft-tissue hemangioma due to the presence of serpiginous enhancing masses with the “dot-in-circle” sign (believed to be due to phleboliths).