title: The diagnosis of osteomyelitis in diabetes using erythrocyte sedimentation rate: a pilot study.
abstract: Osteomyelitis secondary to diabetic foot infections can lead to proximal amputation if not diagnosed in a timely and accurate manner. The authors have found no studies to date that correlate a specific erythrocyte sedimentation rate with osteomyelitis. A retrospective chart review of 29 diabetic patients admitted to the hospital with diagnoses of osteomyelitis or cellulitis of the foot during a 1-year period was performed. Of the various lab values and demographic factors compared, erythrocyte sedimentation rate was the only measure that differed significantly between the two groups. A receiver operating characteristic curve was used to obtain the optimal cutoff value of 70 mm/h, a level above which osteomyelitis was present with the highest sensitivity (89.5%) and highest specificity (100%), along with a positive predictive value of 100% and a negative predictive value of 83%. This study shows that in combination with clinical suspicion in diabetic foot infections, the erythrocyte sedimentation rate is highly predictive of osteomyelitis, and that the value of 70 mm/h is the optimal cutoff to predict accurately the presence or absence of bone infection.
authors.affiliation: Illinois Masonic Medical Center, 3000 N Halsted, Ste 500, Chicago, IL 60657, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Kaleta
authors.forename: J W
authors.initials: JW
authors.lastname: Fleischli
authors.forename: C H
authors.initials: CH
authors.lastname: Reilly
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001799:Blood Sedimentation; D002481:Cellulitis / Q000097:blood / Q000175:diagnosis; D003627:Data Interpretation, Statistical; D017719:Diabetic Foot / Q000097:blood / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000097:blood / Q000175:diagnosis*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012737:Sex Factors