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Evaluating diabetic foot infection with magnetic resonance imaging: Kuwait experience
Hanaa A Al-Khawari1, Osama M Al-Saeed, Taleb H Jumaa
1Department of Radiology, Faculty of Medicine, Kuwait University, Safat, Kuwait. drhana@yahoo.com
Objective:
The aim of this study was to evaluate the capability of magnetic resonance imaging (MRI) to depict and characterize the changes seen in diabetic foot infections.
Subjects And Methods:
MRI studies of 29 diabetic patients with suspected foot infection were evaluated. Sagittal and transverse T1-weighted images before and after intravenous gadolinium, and transverse fat-suppressed T2-weighted images were performed on the affected regions. The MRI findings were compared to subsequent clinical and/or histopathological findings.
Results:
The MRI findings were: osteomyelitis in 14 patients, abscess in 5, cellulitis in 26, tenosynovitis in 4 and neuropathic joint in 8. Three cases were normal. Pathological confirmations were obtained in 19 patients. MRI and histological diagnosis were in concordance in 79% of osteomyelitis cases, 100% of neuropathy cases and 100% of cellulitis cases. The sensitivity and specificity of MRI in diagnosing osteomyelitis were 100 and 63%, respectively. The positive predictive and negative predictive values, and the accuracy were 79, 100 and 84%, respectively. MRI helped surgical planning for limb salvage procedures in 6 of the osteomyelitis cases and in a cellulitis case.
Conclusion:
The results indicate that MRI is a sensitive and accurate imaging modality for the evaluation of foot infections in diabetic patients and for planning proper treatment.
Insights
Magnetic resonance imaging (MRI) is a sensitive and accurate tool for diagnosing diabetic foot infections, including osteomyelitis and cellulitis. This imaging technique aids in surgical planning for limb salvage procedures, improving patient outcomes.
Area of Science:
- Radiology
- Diabetology
- Infectious Diseases
Background:
- Diabetic foot infections are a significant cause of morbidity and limb loss.
- Accurate diagnosis is crucial for effective treatment and limb salvage.
Purpose of the Study:
- To assess the effectiveness of magnetic resonance imaging (MRI) in identifying and characterizing diabetic foot infections.
- To compare MRI findings with clinical and histopathological diagnoses.
Main Methods:
- MRI scans (T1-weighted, fat-suppressed T2-weighted, with and without gadolinium) were performed on 29 diabetic patients with suspected foot infections.
- MRI findings were correlated with subsequent clinical and/or histopathological results.
Main Results:
- MRI detected various infections including osteomyelitis (14 patients), abscess (5), cellulitis (26), and tenosynovitis (4).
- High concordance rates were observed between MRI and histopathology for osteomyelitis (79%), neuropathy (100%), and cellulitis (100%).
- MRI demonstrated 100% sensitivity and 63% specificity for osteomyelitis, with an overall accuracy of 84%.
Conclusions:
- MRI is a highly sensitive and accurate imaging modality for evaluating diabetic foot infections.
- MRI findings assist in surgical planning, including limb salvage procedures, for diabetic patients with foot infections.
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Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...