Original article| Volume 13, ISSUE 2, P159-163, June 1989

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

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      Abstract

      Determining whether osteomyelitis is present in patients with foot infections represents a significant diagnostic challenge. As bone uptake with nuclide scans can be affected by soft tissue infection, we performed computed tomography (CT) on seven patients to see if marrow or bone abnormalities could be seen and used to predict the presence or absence of osteomyelitis. The CT scans correctly predicted the presence or absence of osteomyelitis in all seven patients. Four patients had osteomyelitis and three patients did not. Nuclide bone scans had one false-positive and one false-negative result. In this small series, CT proved helpful in evaluating foot problems.

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      References

        • Park H.M.
        • Wheat L.J.
        • Siddiqui A.R.
        • et al.
        Scintigraphic evaluation or diabetic osteomyelitis: concise communication.
        J Nucl Med. 1982; 23: 569-573
        • Park H.
        • Wheat J.
        • Siddiqui A.
        • Burt R.
        • Robb J.
        • Wellman H.N.
        Three phase bone scan in diabetic foot.
        J Nucl Med. 1979; 20: 602-603
        • Seldin D.W.
        • Heiken J.P.
        • Feldman F.
        • Alderson P.O.
        Effect of soft-tissue pathology on detection of pedal osteomyelitis in diabetes.
        J Nucl Med. 1985; 26: 988-993
        • Shafer R.B.
        • Edeburn G.F.
        Can the three-phase bone scan differentiate osteomyelitis from metabolic or metastatic bone disease?.
        Clin Nucl Med. 1984; 9: 373-377
        • Mendelson E.B.
        • Fisher M.R.
        • Deschler T.W.
        • Rogers L.F.
        • Hendrix R.W.
        • Spies S.
        Osteomyelitis in the diabetic foot: a difficult diagnostic challenge.
        RadioGraphics. 1983; 3: 248-261
        • Alazraki N.
        • Dries D.
        • Datz F.
        • Lawrence P.
        • Greenberg E.
        • Taylor Jr., A.
        Value of a 24-hour image (four-phase bone scan) in assessing osteomyelitis in patients with peripheral vascular disease.
        J Nucl Med. 1985; 26: 711-717
        • Raptopoulos V.
        • Doherty P.W.
        • Goss T.P.
        • King M.A.
        • Johnson K.
        • Gantz N.M.
        Acute osteomyelitis: advantage of white cell scans in early detection.
        AJR. 1982; 139: 1077-1082
        • Kuhn J.P.
        • Berger P.E.
        Computed tomographic diagnosis of osteomyelitis.
        Radiology. 1979; 130: 503-506
        • Hermann G.
        • Rose J.S.
        Computed tomography in bone and soft tissue pathology of the extremities.
        J Comput Assist Tomogr. 1979; 3: 58-66
        • Hald Jr, J.D.
        • Sudmann E.
        Acute hematogenous osteomyelitis.
        Acta Radiol Diagn. 1982; 23: 55-58
        • Ram P.C.
        • Martinez S.
        • Korobkin M.
        • Breiman R.S.
        • Gallis H.R.
        • Harrelson J.M.
        CT detection of intraosseous gas: a new sign of osteomyelitis.
        AJR. 1981; 137: 721-723
        • Lewin J.S.
        • Rosenfield N.S.
        • Hoffer P.B.
        • Downing D.
        Acute osteomyelitis in children: combined Tc-99m and Ga-67 imaging.
        Radiology. 1986; 158: 795-804
        • Wheat J.
        Diagnostic strategies in osteomyelitis.
        Am J Med. 1985; 78: 218-224
        • Eymontt M.J.
        • Alavi A.
        • Dalinka M.K.
        • Kyle G.C.
        Bone scintigraphy in diabetic osteoarthropathy.
        Radiology. 1981; 140: 475-477
        • Wald E.R.
        • Mirro R.
        • Gartner J.C.
        Pitfalls in the diagnosis of acute osteomyelitis by bone scan.
        Clin Pediatr. 1980; 19: 597-601
        • Hart T.J.
        • Healey K.
        Diabetic osteoarthropathy versus diabetic osteomyelitis.
        J Foot Surg. 1986; 25: 464-468
        • Sartoris D.J.
        • Devine S.
        • Resnick D.
        • et al.
        Plantar compartmental infection in the diabetic foot. The role of computed tomography.
        Invest Radiol. 1985; 20: 772-784
        • Glynn Jr., T.P.
        Marked gallium accumulation in neurogenic arthropathy.
        J Nucl Med. 1981; 22: 1016-1017