title: Controversies regarding radiological changes and variables predicting amputation in a surgical series of diabetic foot osteomyelitis.
abstract: BACKGROUND
  To investigate if radiological changes have any influence on the outcomes of surgical treatment of diabetic foot osteomyelitis.
  
  
  METHODS
  Data of patients included in a prospective cohort who underwent surgical treatment for definitive osteomyelitis were analyzed. Cases were classified according to radiological changes as "early osteomyelitis" when no radiological changes were found or in cases showing periosteal elevation and/or subcortical demineralization and/or cortical disruption. Cases showing sequestra and/or gross bone destruction were classified as "advanced osteomyelitis".
  
  
  RESULTS
  Early osteomyelitis was defined according to radiological findings in 37 cases (45.7%) and advanced in 44 (54.3%). Advanced osteomyelitis was not associated with the risk of undergoing amputation.
  
  
  CONCLUSIONS
  The bone changes seen in simple X-rays in cases of osteomyelitis do not have any prognostic value when surgical treatment is undertaken. The outcomes are more related to soft tissue involvement than bone destruction seen in simple X-rays.
authors.affiliation: Surgery Department, Diabetic Foot Unit, La Paloma Hospital, Las Palmas de Gran Canaria, Spain. javiaragon@telefonica.net
authors.forename: Javier
authors.initials: J
authors.lastname: Aragón-Sánchez
authors.forename: Jose L
authors.initials: JL
authors.lastname: Lázaro-Martínez
authors.forename: Nalini
authors.initials: N
authors.lastname: Campillo-Vilorio
authors.forename: Yurena
authors.initials: Y
authors.lastname: Quintana-Marrero
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Hernández-Herrero
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D017719:Diabetic Foot / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D010019:Osteomyelitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011859:Radiography; D016896:Treatment Outcome