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Nicola Carlo BIANCO
Giulia D'AMBRA
Salvatore LUCCHESI
Daniele PERLA
Consolato GULLI'


Diabetic foot, Osteomyelitis, Radiography, Magnetic resonance imaging


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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