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-
1.
Brem H, Sheehan P, Rosenberg HJ, et al: Evidence-based protocol for diabetic foot ulcers. Plast Reconstr Surg 117: 193S, 2006.
-
2.
Donovan A, Schweitzer ME: Current concepts in imaging diabetic pedal osteomyelitis. Radiol Clin North Am 46: 1105, 2008.
-
3.
Rozzanigo U, Tagliani A, Vittorini E, et al: Role of magnetic resonance imaging in the evaluation of diabetic foot with suspected osteomyelitis. Radiol Med 114: 121, 2008.
-
4.
Gnanasegaran G, Chicklore S, Vijayanathan S, et al: Diabetes and bone: advantages and limitations of radiological, radionuclide and hybrid techniques in the assessment of diabetic foot. Minerva Endocrinol 34: 237, 2009.
-
5.
Lipsky BA, Berendt AR, Deery HG, et al: Infectious Diseases Society of America: Diagnosis and treatment of diabetic foot infections. Plast Reconstr Surg 117: 212S, 2006.
-
6.
Embil JM, Rose G, Trepman E, et al: Oral antimicrobial therapy for diabetic foot osteomyelitis. Foot Ankle Int 27: 771, 2006.
-
7.
Senneville E, Lombart A, Beltrand E, et al: Outcome of diabetic foot osteomyelitis treated nonsurgically: a retrospective cohort study. Diabetes Care 31: 637, 2008.
-
8.
Aragón-Sánchez J: Treatment of diabetic foot osteomyelitis: a surgical critique. Int J Low Extrem Wounds 9: 37, 2010.
-
9.
Ha Van G, Siney H, Danan JP, et al: Treatment of osteomyelitis in the diabetic foot: contribution of conservative surgery. Diabetes Care 19: 1257, 1996.
-
10.
Kowalski TJ, Matsuda M, Sorenson MD, et al: The effect of residual osteomyelitis at the resection margin in patients with surgically treated diabetic foot infection. J Foot Ankle Surg 50: 171, 2011.
-
11.
Morrison WB, Schweitzer ME, Batte WG, et al: Osteomyelitis of the foot: relative importance of primary and secondary MR imaging signs. Radiology 207: 625, 1998.
-
12.
Collins MS, Schaar MM, Wenger DE, et al: T1-weighted MRI characteristics of pedal osteomyelitis. AJR Am J Roentgenol 185: 386, 2005.
-
13.
Russell JM, Peterson JJ, Bancroft LW: MR imaging of the diabetic foot. Magn Reson Imaging Clin N Am 16: 59, 2008.
-
14.
Ahmadi ME, Morrison WB, Carrino JA, et al: Neuropathic arthropathy of the foot with and without superimposed osteomyelitis: MR imaging characteristics. Radiology 238: 622, 2006.
-
15.
Thorning C, Gedroyc WM, Tyler PA, et al: Midfoot and hindfoot bone marrow edema identified by magnetic resonance imaging in feet of subjects with diabetes and neuropathic ulceration is common but of unknown clinical significance. Diabetes Care 33: 1602, 2010.
Efficacy of Magnetic Resonance Imaging in Diagnosing Osteomyelitis in Diabetic Foot Ulcers
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Background
The clinical diagnosis of osteomyelitis is difficult because of neuropathy, vascular disease, and immunodeficiency; also, with no established consensus on the diagnosis of foot osteomyelitis, the reported efficacy of magnetic resonance imaging (MRI) in detecting osteomyelitis and distinguishing it from reactive bone marrow edema is unclear. Herein, we describe a retrospective study on the efficacy of MRI for decision-making accuracy in diagnosing osteomyelitis in diabetic foot ulcers.
Methods
Twelve diabetic patients with infected foot ulcers underwent preoperative MRI between January 1, 2008, and December 31, 2011. The findings were compared with the histopathologic features of 67 parts of 45 resected bones, the cut ends of which were also histopathologically evaluated.
Results
Osteomyelitis was disclosed by MRI and histopathologically confirmed in 30 parts. In contrast, bone marrow edema diagnosed by MRI in 29 parts was confirmed in 23; the other six parts displayed osteomyelitis. Among 17 resected bones, 13 cut ends displayed bone marrow edema and four were normal. All of the wounds healed uneventfully.
Conclusions
In the diagnosis of diabetic foot ulcers, osteomyelitis is often reliably distinguished from reactive bone marrow edema, except in special cases.
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