A 23-year-old male, human immunodeficiency virus status unknown, presented with left heel pain and a draining sinus. Sagittal T1-weighted fat sat, post-contrasted magnetic resonance imaging of the left hind foot demonstrates a small rim-enhancing collection in the calcaneus (solid white arrow) with enhancing inflammatory changes in the remainder of the calcaneus (white arrow with dotted line) and surrounding soft tissues (white arrow with dashed line). A draining sinus was demonstrated on T2W sequences. Tuberculosis was confirmed on Gene Xpert of calcaneal tissue.