title: Clinical Inquiry: What's the best test for underlying osteomyelitis in patients with diabetic foot ulcers?
abstract: Magnetic resonance imaging (MRI) has a higher sensitivity and specificity (90% and 79%) than plain radiography (54% and 68%) for diagnosing diabetic foot osteomyelitis. MRI performs somewhat better than any of several common tests--probe to bone (PTB), erythrocyte sedimentation rate (ESR) >70 mm/hr, C-reactive protein (CRP) >14 mg/L, procalcitonin >0.3 ng/mL, and ulcer size >2 cm²--although PTB has the highest specificity of any test and is commonly used together with MRI. No studies have directly compared MRI with a combination of these tests, which may assist in diagnosis.
authors.affiliation: University of Colorado School of Medicine, Denver, CO, USA.
authors.forename: Morteza
authors.initials: M
authors.lastname: Khodaee
authors.affiliation: University of Colorado School of Medicine, Denver, CO, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Lombardo
authors.affiliation: University of Colorado School of Medicine, Denver, CO, USA.
authors.forename: Linda C
authors.initials: LC
authors.lastname: Montgomery
authors.affiliation: University of Colorado School of Medicine, Denver, CO, USA.
authors.forename: Corey
authors.initials: C
authors.lastname: Lyon
authors.affiliation: Houston Community College, TX, USA.
authors.forename: Cathy
authors.initials: C
authors.lastname: Montoya
mesh_terms: D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D017719:Diabetic Foot / Q000150:complications / Q000175:diagnosis; D005528:Foot / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D010019:Osteomyelitis / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D011859:Radiography; D012680:Sensitivity and Specificity
chemical_list: D002097:C-Reactive Protein