Inflammation, Infection, Arthritides, Diagnostic procedure, SPECT-CT, MR, Conventional radiography, Musculoskeletal system, Extremities
J. Gonzalez Nieto, C. Batz Colvée, M. M. Moreu Gamazo, M. L. Vega Gonzalez, M. J. Moreno Casado; Madrid/ES
Diabetes mellitus is a multi-systemic disease that is associated with significant complications affecting multiple organs being a very common cause of cardiovascular disease,
end-stage renal disease,
and lower extremity non-traumatic amputations.
As the prevalence of diabetes increases,
a number of important complications affecting the muscles,
and feet are being seen more frequently .
neuropathy and an altered immune response are the three major pathological processes that lead to the development of diabetes-related foot complications [2,3,14].
Costs arising from interventions to prevent and treat ulcers,
and from postoperative care are compounded by the economic effects of lost productivity,
and premature mortality .
Motor and sensory neuropathies combine to alter biomechanics and proprioception,
with resultant skin breakdown.
Skin ulceration provides an entry portal for soft-tissue and bone infections.
Anhidrosis due to autonomic neuropathy produces dry skin that is vulnerable to callus formation and cracking,
which contribute to skin ulceration . Also,
the distribution of peripheral atherosclerosis in patients with diabetes is often more distal than in patients without diabetes.
Diabetic patients often show involvement of the arteries below the knee,
especially the tibial and peroneal arteries.
It is frequently more symmetric and multisegmental and stenoses can be seen even in the collateral vessels .
We will describe the main manifestations of the diabetic foot and the role of MRI in the diagnosis of its most important complications: osteomyelitis and neuroarthropathy.
We describe the use of Nuclear Imaging techniques in problematic cases regarding this pathology.