THE ROLE OF SERIAL RADIOGRAPHS TO DIAGNOSE DIABETIC FOOT BONE INFECTION. Serial radiographs and diabetic foot osteomyelitis
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Keywords
Diabetic foot, Osteomyelitis, Radiography, Magnetic resonance imaging
Abstract
Purpose: To evaluate the role of progressive radiographic changes to diagnose diabetic foot osteomyelitis.
Materials and Methods: A retrospective review of databases of our Institution was performed to identify all long-standing diabetic foot patients who underwent two radiographic examinations spaced no more than five weeks apart and a subsequent magnetic resonance (MR) examination from November 2015 to November 2020. A total of 46 patients (32 men, 14 women; mean age, 57.3 years) were identified.
Results: serial radiographs showed 89% sensitivity, 38% specificity, 80% diagnostic accuracy, 87% positive predictive value (PPV), 43% negative predictive value (NPV) to diagnose osteomyelitis (P value < 0,05). Bone destruction was the most reliable radiographic sign with 89% sensitivity, 88% specificity, 89% diagnostic accuracy, 97% PPV, 64% NPV (P value < 0,05).
Conclusion: Progressive bony changes detected by serial radiographs are a useful tool to diagnose diabetic foot osteomyelitis.
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Nicola Carlo BIANCO, Catholic University Rome
Department of Radiological and Hematological Sciences, Catholic University, Rome. Resident in Radiology
Giulia D'AMBRA, Catholic University Rome
Department of Radiological and Hematological Sciences, Catholic University, Rome. Resident in Radiology
Salvatore LUCCHESI, Catholic University Rome
Department of Radiological anf Hematological Sciences, Catholic University, Rome. Resident in Radiology
Elisa LA ROSA, Catholic University Rome
Department of Radiological anf Hematological Sciences, Catholic University, Rome. Resident in Radiology
Amato INFANTE, Fondazione Policlinico Universitario Agostino Gemelli IRCCS - Rome
Fondazione Policlinico Universitario Agostino Gemelli IRCCS - Rome Medical assistant.
Daniele PERLA, Fondazione Policlinico Universitario Agostino Gemelli IRCCS - Rome
Fondazione Policlinico Universitario Agostino Gemelli IRCCS - Rome. Medical assistant.
Consolato GULLI', Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome
Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome. Medical assistant.