Computed tomography as a diagnostic aid in diabetic and other problem feet

Williamson, Brian R. J.; Teates, Charles D.; Phillips, C. Douglas; Croft, Barbara Y.

doi:10.1016/0899-7071(89)90101-0

Cited by 21 publications

(7 citation statements)

References 12 publications

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“…However, ultrasound, computed tomography or magnetic resonance imaging should be considered for initial evaluation of these patients with penetrating injuries [ 8 ]. The CT scans correctly predicted the presence or absence of osteomyelitis and proved helpful in evaluating foot problems [ 9 ]. In our case, we did not do either MRI or bone scan for better evaluation of pathology.…”

Section: Discussionmentioning

confidence: 99%

Neglected Foreign Body, the Cause of Navicular Osteomyelitis in A Paediatric Foot: A Case Report

Chandrashekara¹,

George²,

Al-Marboi³

2013

J Ortho Case Reports

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Introduction:Foreign body injuries with date thorns, metal and wooden splinters are common in Middle East region, as most of it is desert. Some of the injuries lead to cellulitis or abscess formation, if neglected or improperly managed results in osteomyelitis or septic arthritis of foot structures. This is the first report of isolated navicular osteomyelitis following neglected foreign body in a paediatric foot.Case Report:A 10 year old male patient presented with discharging sinus in left mid-foot 3 years after penetrating injury with wooden splinter. The diagnosis of navicular osteomelitis is confirmed with plain radio-graphs. The ultrasound of foot was done to localize the foreign bodies. Patient was treated with complete removal of foreign body (wooden splinters), surgical debridement and combination of IV and oral cloxacillin for period of 6 weeks. At 18 months follow up, patient had painless foot with no recurrence or collapse of navicular bone.Conclusion:The neglected foreign body can result in osteomyelitis of small bones of foot in pediatric patient. The ultrasound is more useful tool in localizing foreign bodies; those are not radio-opaque. Early and prompt diagnosis with adequate treatment of established osteomyelitis by complete removal of foreign body, curettage and antibiotics can give good results.

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Section: Discussionmentioning

confidence: 99%

Neglected Foreign Body, the Cause of Navicular Osteomyelitis in A Paediatric Foot: A Case Report

Chandrashekara¹,

George²,

Al-Marboi³

2013

J Ortho Case Reports

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“…Two published studies of computer tomography (CT) and CT combined with positron emission tomography (PET) scans for the diagnosis of osteomyelitis did not include histopathological examination of bone . A recent prospective study that enrolled 110 patients reported that PET/CT scan had a sensitivity of 81%, specificity of 93%, positive predictive value of 78%, negative predictive value 94% and accuracy of 90%, which was somewhat better than a simultaneous MRI .…”

Section: Diagnosismentioning

confidence: 99%

Expert opinion on the management of infections in the diabetic foot

Lipsky

Peters

Senneville

et al. 2012

Diabetes Metabolism Res

176

155

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SummaryThis update of the International Working Group on the Diabetic Foot incorporates some information from a related review of diabetic foot osteomyelitis (DFO) and a systematic review of the management of infection of the diabetic foot. The pathophysiology of these infections is now well understood, and there is a validated system for classifying the severity of infections based on their clinical findings. Diagnosing osteomyelitis remains difficult, but several recent publications have clarified the role of clinical, laboratory and imaging tests. Magnetic resonance imaging has emerged as the most accurate means of diagnosing bone infection, but bone biopsy for culture and histopathology remains the criterion standard. Determining the organisms responsible for a diabetic foot infection via culture of appropriately collected tissue specimens enables clinicians to make optimal antibiotic choices based on culture and sensitivity results. In addition to culture-directed antibiotic therapy, most infections require some surgical intervention, ranging from minor debridement to major resection, amputation or revascularization. Clinicians must also provide proper wound care to ensure healing of the wound. Various adjunctive therapies may benefit some patients, but the data supporting them are weak. If properly treated, most diabetic foot infections can be cured. Providers practising in developing countries, and their patients, face especially challenging situations.

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“…Another indirect test is the brakial-ankle index, which uses doppler ultrasound to compare the blood flow in arteries in the arm and ankle, which is an indicator of vascular deterioration 8 . Other image studies are also used, but they are normally suitable only for relatively advanced stages 9 10 .…”

mentioning

confidence: 99%

Terahertz imaging for early screening of diabetic foot syndrome: A proof of concept

Hernandez-Cardoso

Rojas-Landeros

Alfaro-Gomez

et al. 2017

Sci Rep

123

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Most people with diabetes suffer some deterioration of the feet. Diabetic foot syndrome causes ulceration in about 15% of cases and such deterioration leads to amputation in about 2.5% of diabetic patients, diminishing their quality of life and generating extraordinary costs for patients and public health systems. Currently, there is no objective method for the detection of diabetic foot syndrome in its early stages. We propose terahertz imaging as a method for the evaluation of such deterioration. This screening method could aid the prevention and medical treatment of this condition in the future.

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Computed tomography as a diagnostic aid in diabetic and other problem feet

Cited by 21 publications

References 12 publications

Neglected Foreign Body, the Cause of Navicular Osteomyelitis in A Paediatric Foot: A Case Report

Neglected Foreign Body, the Cause of Navicular Osteomyelitis in A Paediatric Foot: A Case Report

Expert opinion on the management of infections in the diabetic foot

Terahertz imaging for early screening of diabetic foot syndrome: A proof of concept

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