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Imaging the diabetic foot

R H Gold1, D J Tong, J R Crim

  • 1Department of Radiological Sciences, UCLA School of Medicine 90024-1721, USA.

Skeletal Radiology
|November 1, 1995
PubMed
Summary
This summary is machine-generated.

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Early diagnosis of diabetic foot infections and neuropathy is crucial. Imaging techniques like radiography, MR, and radionuclide scans aid in diagnosing osteomyelitis, with biopsy for confirmation.

Area of Science:

  • Diabetic foot complications
  • Infectious disease
  • Neurology
  • Radiology

Background:

  • Diabetic foot complications, including infection and neuropathy, require timely diagnosis for effective management.
  • Angiopathy and peripheral neuropathy contribute to foot ulcerations and osteomyelitis in diabetic patients.
  • Chronic hyperglycemia leads to ischemia and nerve damage, resulting in diabetic neuroarthropathy.

Purpose of the Study:

  • To outline diagnostic strategies for diabetic foot infections and neuropathy.
  • To review imaging modalities for suspected osteomyelitis in diabetic patients.
  • To guide the selection of appropriate diagnostic procedures based on clinical suspicion and initial findings.

Main Methods:

  • Review of diagnostic imaging techniques for diabetic foot osteomyelitis.

Related Experiment Videos

  • Comparison of radiography, radionuclide scans (99mTc-MDP, 111In white blood cell), and magnetic resonance (MR) imaging.
  • Discussion of percutaneous core biopsy for bone specimen acquisition.
  • Main Results:

    • Plain radiography is the initial imaging choice for suspected osteomyelitis, despite lower sensitivity compared to advanced imaging.
    • Radionuclide scans or MR imaging are recommended when radiographs are normal but suspicion remains high.
    • MR imaging is advised for equivocal radionuclide scans, and 111In white blood cell scans are preferred to exclude osteomyelitis in neuroarthropathy.

    Conclusions:

    • Accurate diagnosis of diabetic foot infection and neuropathy is paramount for successful management.
    • A stepwise imaging approach, starting with radiography and progressing to advanced modalities like MR or specific radionuclide scans, is essential.
    • Percutaneous core biopsy remains the gold standard for obtaining bone for bacteriological confirmation.