Evaluation of magnetic resonance imaging in the diagnosis of osteomyelitis in diabetic foot infections.
To assess the role of magnetic resonance imaging (MRI) in diagnosing osteomyelitis in diabetic foot infections, 47 diabetic patients with clinical suspicion of osteomyelitis, nonhealing foot ulcer, or soft tissue infection of the foot were examined prospectively by MRI and plain radiographs. Pathological confirmation of diagnosis was obtained in 62 bones from 32 patients. In addition, 14 patients with pathological confirmation of diagnosis underwent technetium-99 MDP triple-phase bone and gallium-67 citrate scans. MRI was significantly more sensitive and accurate (P < .01), with equal specificity in comparison to plain radiographs and technetium and gallium scans. MRI also provided a more detailed and accurate depiction of the anatomy. At early clinical follow-up, complete resection of abnormal bone on an MRI scan correlated with clinical healing. In summary, MRI is indicated when plain radiographs are negative for osteomyelitis or when the extent and accurate depiction of the infective process will facilitate surgical planning.
Weinstein
D
D
Department of Orthopaedics, University of Colorado Health Sciences Center, Denver 80262.
Wang
A
A
Chambers
R
R
Stewart
C A
CA
Motz
H A
HA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D048909:Diabetes Complications; D005260:Female; D005534:Foot Diseases / Q000175:diagnosis* / Q000209:etiology; D005710:Gallium Radioisotopes; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D011446:Prospective Studies; D013669:Technetium Tc 99m Medronate
D005710:Gallium Radioisotopes; D013669:Technetium Tc 99m Medronate