title: Proton magnetic resonance spectroscopy in the evaluation of patients with acute Charcot neuro-osteoarthropathy.
abstract: OBJECTIVE
  To evaluate whether bone marrow proton magnetic resonance spectroscopy (MRS) might provide a quantitative parameter able to assess disease activity in acute Charcot neuro-osteoarthropathy (CN).
  
  
  METHODS
  Ten diabetic patients with stage 0 CN were prospectively evaluated at clinical onset and during treatment follow-up. The MRS lipid spectrum was analysed and a lipid polyunsaturation index (PUI) was calculated. Disease recovery was defined as the disappearance of bone marrow oedema as demonstrated on MRI short-tau-inversion-recovery (STIR) images. A 3-T MRI was used.
  
  
  RESULTS
  Inter- and intra-individual PUI measurements generated reproducible results with approximately 7 % and 6 % variation respectively. Baseline PUI values were significantly higher in patients with acute CN compared with controls. Also, a significant positive correlation was observed between baseline PUI values and serum levels of IL-6 and TNF-α. During follow-up a gradual decrease in PUI was observed. The percentage reduction of PUI values at 3 months' follow-up with respect to baseline values showed a negative correlation with recovery time.
  
  
  CONCLUSIONS
  Bone marrow MRS may provide a measurable index that allows progressive evaluation of disease activity in acute CN. MRS may be a complementary tool that can be used to guide clinicians in the management of acute CN patients.
  
  
  CONCLUSIONS
  • Bone marrow MRS demonstrates lipid alterations in acute Charcot neuro-osteoarthropathy (CN). • Bone marrow MRS allows disease activity in acute CN to be evaluated. • MRS could become a new tool in the management of CN.
authors.affiliation: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology, and Radiation Therapy, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy, f.bolacchi@tiscali.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Bolacchi
authors.forename: Luigi
authors.initials: L
authors.lastname: Uccioli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Masala
authors.forename: Laura
authors.initials: L
authors.lastname: Giurato
authors.forename: Valeria
authors.initials: V
authors.lastname: Ruotolo
authors.forename: Marco
authors.initials: M
authors.lastname: Meloni
authors.forename: Eleonora
authors.initials: E
authors.lastname: Baffari
authors.forename: Elenia
authors.initials: E
authors.lastname: Cinelli
authors.forename: Marcello
authors.initials: M
authors.lastname: Cadioli
authors.forename: Ettore
authors.initials: E
authors.lastname: Squillaci
authors.forename: Giovanni
authors.initials: G
authors.lastname: Simonetti
authors.forename: Alberto
authors.initials: A
authors.lastname: Bergamini
mesh_terms: D001177:Arthropathy, Neurogenic / Q000097:blood* / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D003929:Diabetic Neuropathies / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011522:Protons; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013577:Syndrome
chemical_list: D015415:Biomarkers; D008055:Lipids; D011522:Protons