Could X-ray Predict Long-term Complications in Patients with Diabetic Foot Osteomyelitis?
Aroa Tardáguila-García1, Yolanda García-Álvarez, Irene Sanz-Corbalán
1At the Diabetic Foot Unit, Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain, Aroa Tardáguila-García, DPM, PhD; Yolanda García-Álvarez, DPM, PhD; Irene Sanz-Corbalán, DPM, PhD; Mateo López-Moral, DPM, PhD; Raúl J. Molines-Barroso, DPM, PhD; and José Luis Lázaro-Martínez, DPM, PhD, are Podiatrists. The authors have disclosed no financial relationships related to this article. Submitted July 19, 2021; accepted in revised form October 1, 2021.
Objective:
To analyze the association between radiologic changes on plain X-rays in patients with diabetic foot osteomyelitis and the development of complications at the 1-year follow-up.
Methods:
A prospective, observational study was conducted involving 115 patients with diabetic foot osteomyelitis. X-ray features that were evaluated during 1-year follow-up visits included affected bone marrow, active periosteal reaction, sequestrum, cortical disruption, and other types of signs. Researchers analyzed the association between the presence of X-ray changes and complication development, such as bone or soft tissue infections, ulcer recurrence, reulceration, amputation, death, and other diabetic foot disease-related events.
Results:
During follow-up, of 115 patients included in the study, 33 patients (28.7%) showed radiologic changes, and 85 (73.9%) developed complications. The presence of radiologic changes after ulcer healing had a significant association with complication development during the 1-year follow-up in addition to those found at different follow-up visits. Patients who showed radiologic changes had higher percentages of complications during the 1-year follow-up, and patients without radiologic changes had lower percentages of complications.
Conclusions:
The presence of radiologic changes is related to the development of complications in patients who suffer from diabetic foot osteomyelitis.
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