Osteomyelitis of the foot in diabetic patients: Evaluation with pain film, 99mTc-MDP bone scintigraphy, and MR imaging

W. T C Yuh, J. D. Corson, H. M. Baraniewski, K. Rezai, A. R. Shamma, M. H. Kathol, Y. Sato, G. Y. El-Khoury, Donald Hawes, C. E. Platz, R. R. Cooper, R. J. Corry

Research output: Contribution to journalArticle

144 Citations (Scopus)

Abstract

Diagnosis of osteomyellitis of the foot in diabetic patients may be difficult because of the coexistence of chronic cellulitis, vascular insufficiency, and peripheral neuropathy. This study compared the diagnostic accuracies of plain films, bone scans, and MR imaging studies in diabetic patients with suspicion of osteomyelitis of the foot. Twenty-nine plain radiographs, 20 bone scans, and 30 MR studies were obtained in 24 patients. Twenty-nine bones from 14 patients were pathologically proved either positive (25 bones) or negative (four bones) for osteomyelitis. Another 15 bones (10 patients) studied with MR had no pathologic proof, but the bones healed with only local wound care and/or a short course of oral antibiotics. These patients had trauma, cellulitis, or unhealed ulcers. The sensitivity and specificity of plain films were both 75%. Bone scans had a very low specificity (100% false-positive rate). A negative bone scan should strongly exclude the probability of osteomyelitis. Unlike the findings in previous reports, MR had much higher sensitivity and specificity than bone scans in detecting osteomyelitis in diabetic patients. When the 10 patients without pathologic proof (those who presumably had neuroarthropathy, vascular insufficiency, and/or cellulitis) were included, the sensitivity and specificity of all three techniques decreased. Our experience with this small group of patients suggests that MR is a useful imaging technique for diagnosing osteomyelitis of the foot in diabetic patients.

Original languageEnglish (US)
Pages (from-to)795-800
Number of pages6
JournalAmerican Journal of Roentgenology
Volume152
Issue number4
StatePublished - 1989
Externally publishedYes

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Technetium Tc 99m Medronate
Diabetic Foot
Osteomyelitis
Radionuclide Imaging
Bone and Bones
Pain
Cellulitis
Motion Pictures
Sensitivity and Specificity
Blood Vessels
Wounds and Injuries
Peripheral Nervous System Diseases
Ulcer
Foot
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Yuh, W. T. C., Corson, J. D., Baraniewski, H. M., Rezai, K., Shamma, A. R., Kathol, M. H., ... Corry, R. J. (1989). Osteomyelitis of the foot in diabetic patients: Evaluation with pain film, 99mTc-MDP bone scintigraphy, and MR imaging. American Journal of Roentgenology, 152(4), 795-800.

Osteomyelitis of the foot in diabetic patients : Evaluation with pain film, 99mTc-MDP bone scintigraphy, and MR imaging. / Yuh, W. T C; Corson, J. D.; Baraniewski, H. M.; Rezai, K.; Shamma, A. R.; Kathol, M. H.; Sato, Y.; El-Khoury, G. Y.; Hawes, Donald; Platz, C. E.; Cooper, R. R.; Corry, R. J.

In: American Journal of Roentgenology, Vol. 152, No. 4, 1989, p. 795-800.

Research output: Contribution to journalArticle

Yuh, WTC, Corson, JD, Baraniewski, HM, Rezai, K, Shamma, AR, Kathol, MH, Sato, Y, El-Khoury, GY, Hawes, D, Platz, CE, Cooper, RR & Corry, RJ 1989, 'Osteomyelitis of the foot in diabetic patients: Evaluation with pain film, 99mTc-MDP bone scintigraphy, and MR imaging', American Journal of Roentgenology, vol. 152, no. 4, pp. 795-800.
Yuh, W. T C ; Corson, J. D. ; Baraniewski, H. M. ; Rezai, K. ; Shamma, A. R. ; Kathol, M. H. ; Sato, Y. ; El-Khoury, G. Y. ; Hawes, Donald ; Platz, C. E. ; Cooper, R. R. ; Corry, R. J. / Osteomyelitis of the foot in diabetic patients : Evaluation with pain film, 99mTc-MDP bone scintigraphy, and MR imaging. In: American Journal of Roentgenology. 1989 ; Vol. 152, No. 4. pp. 795-800.
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