Dr. Thomas Colletti
A serious complication of a chronic or acute diabetic foot ulcer is the development of osteomyelitis. Osteomyelitis increases the risk of amputation and hospitalization, and typically requires a prolonged course of intravenous antibiotics, with or without surgery, for treatment. Additionally, the primary cause of non-traumatic lower extremity amputations is diabetic foot infection. Prompt and accurate diagnosis is imperative in the treatment of patients with osteomyelitis of the foot. There does not currently exist a clear algorithm for diagnosis of osteomyelitis and this gray area can lead to excessive imaging and testing, and delays in treatment once osteomyelitis is diagnosed. In the absence of osteomyelitis on plain radiographs, MRI is the gold standard for early detection. Patients with an elevated CRP, WBCs, ESR and positive Probe-To-Bone test with an acute infection or chronic wound, should be further evaluated for osteomyelitis with an MRI.
Willis A. Diagnosing Osteomyelitis in the Diabetic Foot: When is MRI Indicated?. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2022; 4(4).
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