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Imaging techniques in the diabetic foot

L G Newman1

  • 1Division of Endocrinology and Metabolism, Mount Sinai Medical Center, New York, New York, USA.

Clinics in Podiatric Medicine and Surgery
|January 1, 1995
PubMed
Summary
This summary is machine-generated.

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Diabetic foot ulcers often involve undetected osteomyelitis. Leukocyte scanning is more sensitive than other imaging for diagnosing this bone infection, guiding timely treatment.

Area of Science:

  • Infectious Diseases
  • Diabetic Complications
  • Diagnostic Imaging

Background:

  • Osteomyelitis is a common complication of diabetic foot ulcers, frequently undetected clinically.
  • Accurate diagnosis of osteomyelitis is crucial for effective treatment and limb salvage in diabetic patients.

Purpose of the Study:

  • To evaluate the diagnostic performance of leukocyte scanning compared to conventional imaging methods for osteomyelitis in diabetic foot ulcers.
  • To establish guidelines for the diagnosis and management of osteomyelitis in diabetic foot ulcers based on ulcer depth and diagnostic test sensitivity.

Main Methods:

  • Leukocyte scanning using indium oxyquinoline was compared with radiographs, bone scans, and MR imaging.
  • Ulcer depth and bone exposure were assessed.

Related Experiment Videos

  • Prevalence of osteomyelitis was determined in different ulcer categories.

    • Main Results:

    • Leukocyte scanning demonstrated higher sensitivity than radiographs, bone scans, and MR imaging in diagnosing osteomyelitis.
    • Osteomyelitis prevalence was 100% in ulcers exposing bone and 82% in moderately deep ulcers.
    • Radiographs are recommended for shallow ulcers, followed by leukocyte scans if negative.

    Conclusions:

    • Leukocyte scanning is a highly sensitive tool for diagnosing osteomyelitis in diabetic foot ulcers.
    • Prompt treatment for osteomyelitis is recommended for ulcers with bone exposure or significant depth.
    • Bone biopsy and culture are essential for guiding antibiotic therapy when feasible.