Role of Magnetic Resonance Imaging in Diabetic Foot: A Cross-sectional Study
Introduction: Diabetes related foot problems like osteomyelitis and Charcot (neuro-osteoarthropathy) are associated with high morbidity and high healthcare costs. Soft tissue and bone infection involving the foot is particularly common in patients with diabetes mellitus. Osteomyelitis and neuropathi...
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| Format: | Article |
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JCDR Research and Publications Private Limited
2022-01-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://www.jcdr.net/articles/PDF/15918/51508_CE(Ra1)_F(SS)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdf |
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| author | Shriram Thamaraiselvan Jayakrishnan Ramankutty Jayakumar Shibu Pottayil Srikanth Moorthy Uma Narayanamurthy |
| author_facet | Shriram Thamaraiselvan Jayakrishnan Ramankutty Jayakumar Shibu Pottayil Srikanth Moorthy Uma Narayanamurthy |
| author_sort | Shriram Thamaraiselvan |
| collection | DOAJ |
| description | Introduction: Diabetes related foot problems like osteomyelitis and Charcot (neuro-osteoarthropathy) are associated with high morbidity and high healthcare costs. Soft tissue and bone infection involving the foot is particularly common in patients with diabetes mellitus. Osteomyelitis and neuropathic osteoarthropathy often co-exists in diabetes. Differentiating between these two entities is often difficult but crucial as the management may differ significantly.
Aim: To assess the role of Magnetic Resonance Imaging (MRI) in diabetic foot and its ability to identify features which help to reliably differentiate infection from neuropathy and to describe the MRI imaging findings of infection and neuropathic changes in diabetic foot.
Materials and Methods: The present cross-sectional study was conducted in Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India, from June 2013 to October 2015. All diabetic patients with suspected osteomyelitis or charcot who were referred for MRI were included. MRI was interpreted based on the following parameters location, distribution of oedema pattern, deformity, soft tissue changes and bone marrow signal change. Forty eight patients with diabetic foot, who underwent foot surgery with debridement or drainage and MR findings of the patient were compared with histopathology or culture respectively. Comparison of MR findings were also done with Computed Tomography (CT)/Positron Emission Tomography (PET) wherever available.
Results: In this study, MRI findings with focal single bone involvement along with diffuse marrow oedema pattern, absence of deformity, forefoot/hindfoot location, presence of soft tissue changes like ulcer/sinus tract/fistulas and abscess formation were in favour of osteomyelitis. Several bones and joints involvement along with subchondral/periarticular location, presence of deformity, absence of soft tissue changes and midfoot location were in favour of Charcot’s.
Conclusion: The MRI was found to be the most reliable and sensible tool for imaging techniques to differentiate osteomyelitis with diabetic neuropathic arthropathy, with the sensitivity and specificity of MRI as 83.3% and 77.8%, respectively. |
| first_indexed | 2024-04-10T19:04:46Z |
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| id | doaj.art-a3182f4656ae4c809978d9915f6f2a9b |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-10T19:04:46Z |
| publishDate | 2022-01-01 |
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| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-a3182f4656ae4c809978d9915f6f2a9b2023-01-31T04:14:36ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-01-01161TC24TC2810.7860/JCDR/2022/51508.15918Role of Magnetic Resonance Imaging in Diabetic Foot: A Cross-sectional StudyShriram Thamaraiselvan0Jayakrishnan Ramankutty Jayakumar1Shibu Pottayil2Srikanth Moorthy3Uma Narayanamurthy4Assistant Professor, Department of Radiodiagnosis, Aarupadai Veedu Medical College, Puducherry, India.Assistant Professor, Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India.Professor, Department of Radiodiagnosis, Amrita Institute of Medical Sciences, Kochi, Kerala, India.Professor and Head, Department of Radiodiagnosis, Amrita Institute of Medical Sciences, Kochi, Kerala, India. Associate Professor, Department of Pharmacology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.Introduction: Diabetes related foot problems like osteomyelitis and Charcot (neuro-osteoarthropathy) are associated with high morbidity and high healthcare costs. Soft tissue and bone infection involving the foot is particularly common in patients with diabetes mellitus. Osteomyelitis and neuropathic osteoarthropathy often co-exists in diabetes. Differentiating between these two entities is often difficult but crucial as the management may differ significantly. Aim: To assess the role of Magnetic Resonance Imaging (MRI) in diabetic foot and its ability to identify features which help to reliably differentiate infection from neuropathy and to describe the MRI imaging findings of infection and neuropathic changes in diabetic foot. Materials and Methods: The present cross-sectional study was conducted in Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India, from June 2013 to October 2015. All diabetic patients with suspected osteomyelitis or charcot who were referred for MRI were included. MRI was interpreted based on the following parameters location, distribution of oedema pattern, deformity, soft tissue changes and bone marrow signal change. Forty eight patients with diabetic foot, who underwent foot surgery with debridement or drainage and MR findings of the patient were compared with histopathology or culture respectively. Comparison of MR findings were also done with Computed Tomography (CT)/Positron Emission Tomography (PET) wherever available. Results: In this study, MRI findings with focal single bone involvement along with diffuse marrow oedema pattern, absence of deformity, forefoot/hindfoot location, presence of soft tissue changes like ulcer/sinus tract/fistulas and abscess formation were in favour of osteomyelitis. Several bones and joints involvement along with subchondral/periarticular location, presence of deformity, absence of soft tissue changes and midfoot location were in favour of Charcot’s. Conclusion: The MRI was found to be the most reliable and sensible tool for imaging techniques to differentiate osteomyelitis with diabetic neuropathic arthropathy, with the sensitivity and specificity of MRI as 83.3% and 77.8%, respectively.https://www.jcdr.net/articles/PDF/15918/51508_CE(Ra1)_F(SS)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdfcharcot diseasefoot magnetic resonance imagingneuropathic jointosteomyelitisulcer of foot |
| spellingShingle | Shriram Thamaraiselvan Jayakrishnan Ramankutty Jayakumar Shibu Pottayil Srikanth Moorthy Uma Narayanamurthy Role of Magnetic Resonance Imaging in Diabetic Foot: A Cross-sectional Study Journal of Clinical and Diagnostic Research charcot disease foot magnetic resonance imaging neuropathic joint osteomyelitis ulcer of foot |
| title | Role of Magnetic Resonance Imaging in Diabetic Foot: A Cross-sectional Study |
| title_full | Role of Magnetic Resonance Imaging in Diabetic Foot: A Cross-sectional Study |
| title_fullStr | Role of Magnetic Resonance Imaging in Diabetic Foot: A Cross-sectional Study |
| title_full_unstemmed | Role of Magnetic Resonance Imaging in Diabetic Foot: A Cross-sectional Study |
| title_short | Role of Magnetic Resonance Imaging in Diabetic Foot: A Cross-sectional Study |
| title_sort | role of magnetic resonance imaging in diabetic foot a cross sectional study |
| topic | charcot disease foot magnetic resonance imaging neuropathic joint osteomyelitis ulcer of foot |
| url | https://www.jcdr.net/articles/PDF/15918/51508_CE(Ra1)_F(SS)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdf |
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