Diagnostic performance of diffusion-weighted MR imaging in differentiation of diabetic osteoarthropathy and osteomyelitis in diabetic foot

Razek, Ahmed Abdel Khalek Abdel; Samir, Sieza

doi:10.1016/j.ejrad.2017.02.015

Cited by 41 publications

(31 citation statements)

References 35 publications

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“…One prospective study not included in this analysis also found that for diagnosing osteomyelitis in patients with Charcot neuroarthropathy, 18 F‐FDG‐labelled leukocyte PET/CT had the same sensitivity (83.3%) as contrast to enhanced MRI, but its specificity was 100%, compared with 63.6%. One small prospective study of low quality found that diffusion‐weighted MRI for the diagnosis of diabetic foot osteomyelitis had low performance characteristics (sensitivity 64.6% and accuracy 63.7%). However, when using a calculated apparent diffusion coefficient, two reviewers were able to differentiate diabetic osteoarthropathy from osteomyelitis with an accuracy of 94% and 93%, with excellent interobserver agreement.…”

Section: Resultsmentioning

confidence: 99%

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Diagnosis of infection in the foot in diabetes: a systematic review

Senneville

Lipsky

Abbas

et al. 2020

Diabetes Metabolism Res

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Background Securing an early accurate diagnosis of diabetic foot infections and assessment of their severity are of paramount importance since these infections can cause great morbidity and potentially mortality and present formidable challenges in surgical and antimicrobial treatment. Methods In June 2018, we searched the literature using PuEbMed and EMBASE for published studies on the diagnosis of diabetic foot infection. On the basis of predetermined criteria, we reviewed prospective controlled, as well as noncontrolled, studies in any language, seeking translations for those not in English. We then developed evidence statements on the basis of the included papers. Results From the 4242 records screened, we selected 35 papers that met our inclusion criteria. The quality of all but one of the evidence statements was low because of the weak methodology of nearly all of the studies. The available data suggest that diagnosing diabetic foot infections on the basis of clinical signs and symptoms and classified according to the International Working Group of the Diabetic Foot scheme correlates with the patient's likelihood of ulcer healing, of lower extremity amputation, and risk of death. Elevated levels of selected serum inflammatory markers are supportive, but not diagnostic, of soft tissue or bone infection. In patients with suspected diabetic foot osteomyelitis, both a positive probe‐to‐bone test and an elevated erythrocyte sedimentation rate are strongly associated with its presence. Culturing tissue samples of soft tissues or bone, when care is taken to avoid contamination, provides more accurate microbiological information than culturing superficial (swab) samples. Plain X‐ray remains the first‐line imaging examination when there is suspicion of diabetic foot osteomyelitis, but advanced imaging methods help in cases when either the diagnosis or the localization of infection is uncertain. Conclusion The results of this first reported systematic review on the diagnosis of diabetic foot infections provide some guidance for clinicians, but there is a need for more prospective controlled studies of high quality.

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Section: Resultsmentioning

confidence: 99%

“…References: Lauri et al, Ertugrul et al, Johnson et al, Nawaz et al, Newman et als, Shagos et al, Blume et al, Treglia et al, Rastogi et al, Abdel Razek and Samir, Aslangul et al, and Poirier et al…”

Section: Resultsmentioning

confidence: 99%

Diagnosis of infection in the foot in diabetes: a systematic review

Senneville

Lipsky

Abbas

et al. 2020

Diabetes Metabolism Res

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“…With the DXA method, the presence of degenerative changes, such as aortic calcifications, vertebral osteophytes, facet joint degenerations, and sclerosis of the IVD, may lead to falsely increased lumbar BMD. [ 9 ] In the future, other methods such as diffusion-weighted MRI may detect BMD, [ 27 , 28 ] but in this study, we excluded patients aged more than 60 years, a population more likely to develop these confounding factors. Additionally, since a decrease in BMD values is observed in postmenopausal women, we included only premenopausal women.…”

Section: Discussionmentioning

confidence: 99%

Effect of bone mineral density on lumbar discs in young adults

Keser

Atici²,

Çelikoğlu³

et al. 2017

Medicine

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Bone mineral density (BMD) might be a risk factor for lumbar disc herniation (LDH) in young adults, but there is not enough data concerning this effect. Several studies have been performed on elderly and osteoporotic patients. Thus, we aimed to investigate the effect of BMD on the etiopathogenesis of LDH in young adults.One hundred patients (mean age: 38.45 ± 8.92 years; 50 men and 50 women) were enrolled this case–control study and classified into 2 groups, as follows. The case group (G-I) included 50 patients with symptomatic LDH who were hospitalized in the Physical Medicine and Rehabilitation Clinic, and the control group (G-II) included 50 patients with lower back pain but no finding of LDH detected using magnetic resonance imaging. Patients in the G-II were recruited among those admitted to the outpatient clinic at the time of the study, and whose age and sex were matched to those of the study group. Women in menopause were excluded from the study. BMD analysis by dual energy x-ray absorptiometry was performed in both groups.The mean values of the femur neck and lumbar spine BMD were 1.02 ± 0.13 and 1.19 ± 0.14 g/cm2, respectively. There was no statistically significant relationship between BMD and LDH in this population.This result may mean that in a normal range, BMD does not exert a compressive load on the lumbar discs in young adults and therefore may not lead to LDH by this mechanism and the load.

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“…The incidence of osteosarcoma in the general population is 1 per million per year, but is higher in adolescence, in which the annual incidence peaks at about 10 per million per year at 15 to 19 years of age. [1,2] There are several imaging tests for OS diagnosis, such as X-ray, magnetic resonance imaging (MRI), [3] bone scan, and CT. [4] These imaging tests play important roles in diagnosis and characterization, which will help guide osteosarcoma therapy. [5,6]…”

Section: Introductionmentioning

confidence: 99%