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The diagnosis of osteomyelitis of the foot in diabetes: microbiological examination vs. magnetic resonance imaging and labelled leucocyte scanning
Author(s) -
Ertugrul M. B.,
Baktiroglu S.,
Salman S.,
Unal S.,
Aksoy M.,
Berberoglu K.,
Calangu S.
Publication year - 2006
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2006.01887.x
Subject(s) - medicine , osteomyelitis , histopathology , diabetic foot , magnetic resonance imaging , diabetes mellitus , physical examination , amputation , histopathological examination , foot (prosody) , bone infection , radiology , surgery , pathology , linguistics , philosophy , endocrinology
Aims Foot infections and their sequelae are among the most common and severe complications of diabetes mellitus. As diabetic patients with foot infections develop osteomyelitis and may progress to amputation, early diagnosis of osteomyelitis is critical. Methods We compared the diagnostic values of labelled leucocyte scanning with Tc 99 m, magnetic resonance imaging (MRI) and microbiological examination of bone tissue specimens with histopathology, the definitive diagnostic procedure. Thirty‐one diabetic patients with foot lesions were enrolled in the study and histopathological examination was performed in all. Patients had clinically suspected foot lesions of ≥ grade 3 according to the classification of Wagner. Results Bone specimens were obtained for histopathological examination. Microbiology had a sensitivity of 92% and specificity of 60%. Labelled leucocyte scanning had a sensitivity of 91%, specificity of 67%, and MRI a sensitivity of 78%, specificity of 60%. Conclusions Microbiological examination may be as useful as and less costly than other diagnostic procedures and is the only method which can guide the choice of antibiotic therapy.