title: Neuropathic osteoarthropathy with and without superimposed osteomyelitis in patients with a diabetic foot.
abstract: Soft tissue and bone infection involving the foot is one of the most common long-term complications of diabetes mellitus, implying a serious impairment in quality of life for patients in the advanced stages of the disease. Neuropathic osteoarthropathy often coexists and differentiating between these two entities is commonly challenging, but crucial, as the management may differ substantially. The importance of correct diagnosis cannot be understated and effective management requires a multidisciplinary approach owing to the complicated nature of therapy in such patients. A missed diagnosis has a high likelihood of major morbidity for the patient, including limb amputation, and over-diagnosis results in a great socioeconomic challenge for healthcare systems, the over-utilization of healthcare resources, and the unwise use of antibiotics. Diagnosis is largely based on clinical signs supplemented by various imaging modalities such as radiography, MR imaging, and hybrid imaging techniques such as F-18 fluorodeoxyglucose-positron emission tomography. In the interests of the management of diabetic foot complications, this review article is aimed on the one hand at providing radiologists with important clinical knowledge, and on the other hand to equip clinicians with relevant radiological semiotics.
authors.affiliation: Institute of Radiology, School of Medicine, Catholic University, Largo A. Gemelli 1, 00168, Rome, Italy. a.leonemd@tiscali.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Leone
authors.affiliation: Department of Diagnostic Imaging, The Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, Shropshire, UK.
authors.forename: Victor N
authors.initials: VN
authors.lastname: Cassar-Pullicino
authors.affiliation: Institute of Radiology, School of Medicine, Catholic University, Largo A. Gemelli 1, 00168, Rome, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Semprini
authors.affiliation: Institute of Radiology, School of Medicine, Catholic University, Largo A. Gemelli 1, 00168, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Tonetti
authors.affiliation: Institute of Radiology, School of Medicine, Catholic University, Largo A. Gemelli 1, 00168, Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Magarelli
authors.affiliation: Institute of Radiology, School of Medicine, Catholic University, Largo A. Gemelli 1, 00168, Rome, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Colosimo
mesh_terms: D001175:Arthrography; D001177:Arthropathy, Neurogenic / Q000150:complications / Q000000981:diagnostic imaging*; D017719:Diabetic Foot / Q000150:complications / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D064847:Multimodal Imaging; D010019:Osteomyelitis / Q000150:complications / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography
keywords: Diabetes mellitus; Diabetic foot; F-18 FDG-PET/CT; MR imaging; Neuropathic osteoarthropathy; Osteomyelitis