title: Leukocyte scanning with 111In is superior to magnetic resonance imaging in diagnosis of clinically unsuspected osteomyelitis in diabetic foot ulcers.
abstract: OBJECTIVE
  To compare the accuracies of MRI and leukocyte scanning in diagnosing clinically unsuspected osteomyelitis in diabetic foot ulcers.
  
  
  METHODS
  A prospective study of 16 diabetic foot ulcers in 12 patients, including both ambulatory and hospitalized patients, was performed at a university medical center. Pedal images were obtained by leukocyte scanning with [111In]oxyquinoline and MRI. Definitive diagnosis of osteomyelitis then was determined by bone biopsy for culture and histology.
  
  
  RESULTS
  Biopsy-proven osteomyelitis was present in 7 (44%) of the 16 foot ulcers. The diagnosis was suspected clinically in 0%. Leukocyte scanning was 100% sensitive, whereas MRI was only 29% sensitive in diagnosing osteomyelitis in diabetic foot ulcers. Specificities were 67 and 78%, respectively. The positive and negative predictive values (70 and 100%, respectively) for the leukocyte scan also were greater than those of MRI (50 and 58%, respectively).
  
  
  CONCLUSIONS
  Leukocyte scanning is superior to MRI in detecting clinically unsuspected osteomyelitis in diabetic foot ulcers.
authors: Department of Medicine, Mount Sinai Medical Center, New York, New York 10029.
authors: L G
authors: LG
authors: Newman
authors: J
authors: J
authors: Waller
authors: C J
authors: CJ
authors: Palestro
authors: G
authors: G
authors: Hermann
authors: M J
authors: MJ
authors: Klein
authors: M
authors: M
authors: Schwartz
authors: E
authors: E
authors: Harrington
authors: M
authors: M
authors: Harrington
authors: S H
authors: SH
authors: Roman
authors: A
authors: A
authors: Stagnaro-Green
mesh_terms: D001706:Biopsy; D001842:Bone and Bones / Q000473:pathology; D048909:Diabetes Complications; D016523:Foot Ulcer / Q000150:complications*; D006801:Humans; D007205:Indium Radioisotopes; D007962:Leukocytes / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods; D009942:Organometallic Compounds; D010019:Osteomyelitis / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D015125:Oxyquinoline / Q000031:analogs & derivatives*; D011877:Radionuclide Imaging
chemical_list: D007205:Indium Radioisotopes; D009942:Organometallic Compounds; C032950:indium oxine; D015125:Oxyquinoline