Learning objectives
1.To illustrate the different imaging findings in diabetic foot complications.
2.To describe challenging and difficult scenarios,
of the diabetic foot complications,
in presurgical and postsurgical contexts.
3.To assess what the surgeon wants to know.
Background
Diabetic mellitus (DM) is a multisystemic disease with increasing prevalence,
significant morbidity,
premature mortality and impact on the healthcare costs.
Peripheral nerve dysfunction related to DM allows the possibility to suffer minor injuries that may remain undiscovered for a long while,
causing deformity,
altered weight bearing,
subsequent osteoarthropaty,
callus and ulceration.
Peripheral artery disease that is frequently present in these patients causes difficulties to heal infections,
leading to surgery treatments like debridement and amputations.(1)(2)
We review,
from our experience,
difficult and challenging scenarios of diabetic...
Findings and procedure details
What the surgeons wants to know in our center is defined below:
1.
Existence and extension of osteomyelitis in presurgical,
postsurgical contexts and discrimination with Charcot neuro-osteoarthropathy (CN).
Fig. 1
2.
Which kind of involvement is existing in the soft tissue (cellulitis,
phlegmon,
gangrene or abscess),
its extension and differences from inflammatory soft tissue affection.
3.
Use of advanced MRI techniques to confirm and best delimitatate of the features in convetional MRI sequences.
4.
To delimitatate and assess the routes of spread and inform about...
Conclusion
Multiparametric MRI is the standard technique for the evaluation of diabetic foot complications.
Knowing and assessing with precision the limits of the disease and differentiate osteomyelitis from CN is primordial to improve the outcome of the patient.
References
[1] D.
W.
Voigt,
C.
N.
Paul,
P.
Edwards,
and P.
Metz,
“Economic study of collagen-glycosaminoglycan biodegradable matrix for chronic wounds.,” Wounds A Compend.
Clin.
Res.
Pract.,
vol.
18,
no.
1,
pp.
1–7,
2006.
[2] European Diabetes Working Party for Older People,
“Clinical Guidelines for Type 2 Diabetes Mellitus (EDWPOP),” Diabetes Metab.,
vol.
37,
no.
3,
pp.
S27–S38,
2011.
[3] C.
Lauri et al.,
“Detection of osteomyelitis in the diabetic foot by imaging techniques: A systematic review and meta-analysis comparing mri,
white blood cell scintigraphy,...