Abstract
Magnetic resonance imaging (MRI) has been recognized as the most accurate imaging
modality for the detection of diabetic foot osteomyelitis. However, how accurately
MRI displays the extent of diabetic foot osteomyelitis in the presence of ischemia
is still unclear. We retrospectively compared the preoperative MRI findings with the
results of histopathologic examinations of resected bones and studied the efficacy
of MRI in the diagnosis of diabetic foot osteomyelitis of different etiologies. A
total 104 bones from 18 foot ulcers in 16 diabetic patients (10 men and 6 women; age
range 42 to 84 years) treated by surgical intervention from 2008 to 2012 was examined.
In 8 neuropathic ulcers, 29 bones were accurately diagnosed in detail using MRI, even
those with severe soft tissue infection. Of 75 bones in 10 ischemic ulcers, only 7
bones evaluated by MRI after revascularization were diagnosed accurately; the other
68 could not be diagnosed because of unclear or equivocal MRI findings. On histopathologic
examination, all the bones were found to be infected through the bone cortex by the
surrounding infected soft tissue, not directly by articulation. Overall, preoperative
MRI is effective in the diagnosis of neuropathic ulcers, but less so of ischemic ones.
Level of Clinical Evidence
Keywords
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Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
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© 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
