title: Can procalcitonin predict bone infection in people with diabetes with infected foot ulcers? A pilot study.
abstract: OBJECTIVE
  The diagnosis of osteomyelitis is a key step of diabetic foot management. Previous studies showed that procalcitonin (PCT), a novel infection marker, is superior to conventional infection markers in the diagnosis of diabetic foot infection. This study aimed to investigate the serum levels of PCT and other conventional infection markers in diabetic persons with and without osteomyelitis.
  
  
  METHODS
  Twenty-four patients (18 male, mean age: 61.9±10.8 years) with infected foot ulcers were prospectively enrolled. Clinical characteristics of the wounds were noted. Blood samples were obtained for biochemical analysis. Magnetic resonance imaging of the foot was performed in all patients to diagnose osteomyelitis.
  
  
  RESULTS
  Osteomyelitis was found in 13 of 24 (54%) patients. PCT levels were 66.7±43.5 pg/ml in patients with osteomyelitis and 58.6±35.5 pg/ml in patients without osteomyelitis. The difference did not reach statistical significance (p=0.627). Erythrocyte sedimentation rate, but not C-reactive protein and white blood cell count, was found significantly higher in patients with osteomyelitis.
  
  
  CONCLUSIONS
  In this group of patients, PCT failed to discriminate patients with bone infection. Erythrocyte sedimentation rate can be used as a marker of osteomyelitis in diabetic persons.
authors.affiliation: Department of Underwater and Hyperbaric Medicine, Gulhane Military Medical Academy Haydapaşa Teaching Hospital, Istanbul, Turkey.
authors.forename: Mesut
authors.initials: M
authors.lastname: Mutluoğlu
authors.forename: Günalp
authors.initials: G
authors.lastname: Uzun
authors.forename: Osman M
authors.initials: OM
authors.lastname: İpcioğlu
authors.forename: Onur
authors.initials: O
authors.lastname: Sildiroglu
authors.forename: Ömer
authors.initials: Ö
authors.lastname: Özcan
authors.forename: Vedat
authors.initials: V
authors.lastname: Turhan
authors.forename: Hakan
authors.initials: H
authors.lastname: Mutlu
authors.forename: Senol
authors.initials: S
authors.lastname: Yildiz
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D048909:Diabetes Complications; D017719:Diabetic Foot / Q000097:blood* / Q000150:complications / Q000378:metabolism; D005260:Female; D016523:Foot Ulcer / Q000097:blood* / Q000150:complications / Q000378:metabolism; D006801:Humans; D007958:Leukocyte Count; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000097:blood* / Q000209:etiology / Q000378:metabolism; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*
chemical_list: C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide