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MR imaging of neuropathic feet in leprosy patients with suspected osteomyelitis
Mario Maas1, Erik J Slim, Agnes F Heoksma
1Department of Radiology, Suite G1-231, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam Zuidoost, The Netherlands. m.maas@amc.uva.nl
Abstract:
This study was undertaken to analyze MRI findings in leprosy patients with neuropathic feet, which are suspected of having osteomyelitis. As far as we know, there is no literature concerning osteomyelitis and MRI in neuropathic leprosy feet at present. Therefore, we have included MRI examination of 18 events of suspected osteomyelitis in 12 leprosy patients. All patients with long-standing neuropathic foot problems were clinically suspected of having osteomyelitis. All patients underwent the MRI protocol with the inclusion of Two Point Dixon Chemical Shift Imaging as a fat-suppression sequence. For the MRI evaluation, we used signs that are described in literature for detecting osteomyelitis in diabetic feet. The primary MRI signs were positive in 17 of 18 patients. The secondary MRI signs were positive in 100% of the patients. Our results show that MRI with the use of Two Point Dixon Chemical Shift Imaging is a promising diagnostic modality to detect osteomyelitis in the presence of neurosteoarthropathic changes in patients with leprosy. Whenever available, MRI could play an important role in detecting osteomyelitis in leprosy patients with long-standing neuropathic feet.
Insights
Magnetic resonance imaging (MRI) effectively detects osteomyelitis in leprosy patients with neuropathic feet. This study highlights MRI
Area of Science:
- Radiology
- Infectious Diseases
- Orthopedics
Background:
- Leprosy frequently causes neuropathic foot complications.
- Osteomyelitis is a challenging complication in neuropathic leprosy feet.
- Limited literature exists on MRI for osteomyelitis in this patient group.
Purpose of the Study:
- To evaluate the utility of MRI in diagnosing osteomyelitis in leprosy patients with neuropathic feet.
- To assess specific MRI findings indicative of osteomyelitis in this population.
- To establish MRI as a diagnostic tool for suspected osteomyelitis in neuropathic leprosy.
Main Methods:
- Retrospective analysis of 18 suspected osteomyelitis cases in 12 leprosy patients.
- Standard MRI protocol including Two Point Dixon Chemical Shift Imaging for fat suppression.
- Utilized MRI criteria established for diagnosing osteomyelitis in diabetic foot.
Main Results:
- Primary MRI signs for osteomyelitis were positive in 17 out of 18 patients (94.4%).
- Secondary MRI signs were positive in all 18 patients (100%).
- Two Point Dixon Chemical Shift Imaging proved effective for fat suppression.
Conclusions:
- MRI, particularly with Two Point Dixon Chemical Shift Imaging, is a promising method for detecting osteomyelitis in neuropathic leprosy feet.
- MRI can accurately identify osteomyelitis even with coexisting neurosteoarthropathic changes.
- MRI should be considered a valuable diagnostic tool for suspected osteomyelitis in leprosy patients with chronic foot problems.
