Current challenge in diabetic foot MR imaging is the modality of choice for the evaluation of bone and soft-tissue infection in diabetic foot, the diagnostic is feasible when is observed low signal intensity on T1-weighted images in bone marrow adjacent to ulceration at predictable sites (1, 2). However when in addition there is early stage of Charcot neuro-osteoarthropathy (CN) or recent surgical changes, diagnosing diabetic foot osteomyelitis (DFO) and evaluating the extension is unfortunately difficult. Examples with feasible diagnostic and with difficult diagnostic of DFO...

Study patients Twenty-two patients with diabetic foot underwent MRI to diagnose osteomyelitis and/or CN, 18 with infected ulcer (7 with CN) and 4 with CN without infection (15 man and 7 woman, mean age 56.59 years, range age 39-82 years). The institutional review board at our institution approved the study and written informed consent was obtained in all patients. Demography and clinical data in Figure 4. MRI protocol MRI studies were performed in a 1.5T scanner (AERA, Siemens) with a CP extremity coil, and routine...

Bones with osteomyelitis showed significant values of ktrans and iAUC significantly higher than those of CN, both small and large ROIs and for both readers (P<0.05). The reliability was from good to excellent in iAUC between different ROI sizes and pathological conditions (0.74-0.92) and only between large ROIs in evaluating ktrans (0.87-0.9), being poor or moderate between small ROIs or using both ROI sizes in ktrans(0.43-0.69). The cut-off values to discriminate DFO of the significant variables with the best reliability and specificity were for large...

DCE-MRI parameters that can help in the differentiation of DMO from bone oedema with excellent reliability were TIC with a small ROI, and Ktrans and iAUC with large ROIs, with slightly better performance in Ktrans than measurements obtained in IAUC, and with a moderate agreement of the TIC.

Donovan A, Schweitzer ME. Use of MR imaging in diagnosing diabetes-related pedal osteomyelitis. Radiographics 2010; 30: 723-36. Schweitzer ME, Daffner RH, Weissman BN, et al. ACR Appropriateness Criteria on suspected osteomyelitis in patients with diabetes mellitus. J.Am.Coll.Radiol., 2008; 5: 881-886. Stäbler A, Doma AB, Baur A, Krüge A, Reiser MF. Reactive bone marrow changes in infectious spondylitis: quantitative assessment with MR imaging. Radiology 2000; 217, 863–868. Martín Noguerol T, Luna Alcalá A, Beltrán LS, Gómez Cabrera M, Broncano Cabrero J, Vilanova JC. Advanced MR Imaging...

Ana Isabel García Díez1,2 [email protected] David Fuster3 Laura Morata2,4 Rubén García5 Daniel Poggio5 Montserrat Del Amo1 Xavier Tomás1 Santiago Sotés1 Jaime Isern1 Jaume Pomés1 1 Department of Radiology 2 Institut d´Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS) 3 Department of Nuclear Medicine. 4 Service of Infectious Diseases 5 Department of Orthopaedics and Traumatology HOSPITAL CLINIC. UNIVERSITAT DE BARCELONA (UB). BARCELONA, SPAIN