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Diagnosing diabetic foot osteomyelitis: narrative review and a suggested 2-step score-based diagnostic pathway for clinicians.

Markanday A - Open Forum Infect Dis (2014)

Bottom Line: This evidence-based review and the proposed diagnostic scoring pathway substratifies the current International Working Group on the Diabetes Foot guidelines for diagnosing diabetic foot osteomyelitis into a convenient 2-step diagnostic pathway for clinicians.A MEDLINE search of English-language articles on diabetic foot osteomyelitis published between 1986 and March 2014 was conducted.Additional articles were also identified through a search of references from the retrieved articles, published guidelines, systematic reviews, and meta-analyses.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases , Fraser Health Authority ; Department of Medicine , Abbotsford Regional Hospital and Cancer Center , Abbotsford, British Columbia , Canada ; Clinical Assistant Professor, University of British Columbia.

ABSTRACT
The diabetic foot infection remains a major cause of morbidity and mortality in many patients and remains a challenging diagnosis for most clinicians. Diagnosis is largely based on clinical signs supplemented by various imaging tests. Magnetic resonance imaging (MRI) is not readily available to many clinicians, and bone biopsy, which is the accepted criterion standard for diagnosis, is rarely performed routinely. This evidence-based review and the proposed diagnostic scoring pathway substratifies the current International Working Group on the Diabetes Foot guidelines for diagnosing diabetic foot osteomyelitis into a convenient 2-step diagnostic pathway for clinicians. This proposed diagnostic approach will need further validation prospectively, but it can serve as a useful diagnostic tool during the initial assessment and management of diabetic foot infections. A MEDLINE search of English-language articles on diabetic foot osteomyelitis published between 1986 and March 2014 was conducted. Additional articles were also identified through a search of references from the retrieved articles, published guidelines, systematic reviews, and meta-analyses.

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Diagnostic pathway for diabetic foot osteomyelitis.
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OFU060F1: Diagnostic pathway for diabetic foot osteomyelitis.

Mentions: There have been some studies evaluating computed tomography (CT) and fluorodeoxyglucose positron emission tomography (FDG-PET) scans for the diagnosis of osteomyelitis. Fluorodeoxyglucose-PET scan has been reported to have high sensitivity ranging from 0.94 to 1.00 and specificity ranging from 0.87 to 1.00 [26]. One study reported even better diagnostic accuracy with the combination of FDG-PET and CT scan [28].


Diagnosing diabetic foot osteomyelitis: narrative review and a suggested 2-step score-based diagnostic pathway for clinicians.

Markanday A - Open Forum Infect Dis (2014)

Diagnostic pathway for diabetic foot osteomyelitis.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4281812&req=5

OFU060F1: Diagnostic pathway for diabetic foot osteomyelitis.
Mentions: There have been some studies evaluating computed tomography (CT) and fluorodeoxyglucose positron emission tomography (FDG-PET) scans for the diagnosis of osteomyelitis. Fluorodeoxyglucose-PET scan has been reported to have high sensitivity ranging from 0.94 to 1.00 and specificity ranging from 0.87 to 1.00 [26]. One study reported even better diagnostic accuracy with the combination of FDG-PET and CT scan [28].

Bottom Line: This evidence-based review and the proposed diagnostic scoring pathway substratifies the current International Working Group on the Diabetes Foot guidelines for diagnosing diabetic foot osteomyelitis into a convenient 2-step diagnostic pathway for clinicians.A MEDLINE search of English-language articles on diabetic foot osteomyelitis published between 1986 and March 2014 was conducted.Additional articles were also identified through a search of references from the retrieved articles, published guidelines, systematic reviews, and meta-analyses.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases , Fraser Health Authority ; Department of Medicine , Abbotsford Regional Hospital and Cancer Center , Abbotsford, British Columbia , Canada ; Clinical Assistant Professor, University of British Columbia.

ABSTRACT
The diabetic foot infection remains a major cause of morbidity and mortality in many patients and remains a challenging diagnosis for most clinicians. Diagnosis is largely based on clinical signs supplemented by various imaging tests. Magnetic resonance imaging (MRI) is not readily available to many clinicians, and bone biopsy, which is the accepted criterion standard for diagnosis, is rarely performed routinely. This evidence-based review and the proposed diagnostic scoring pathway substratifies the current International Working Group on the Diabetes Foot guidelines for diagnosing diabetic foot osteomyelitis into a convenient 2-step diagnostic pathway for clinicians. This proposed diagnostic approach will need further validation prospectively, but it can serve as a useful diagnostic tool during the initial assessment and management of diabetic foot infections. A MEDLINE search of English-language articles on diabetic foot osteomyelitis published between 1986 and March 2014 was conducted. Additional articles were also identified through a search of references from the retrieved articles, published guidelines, systematic reviews, and meta-analyses.

No MeSH data available.


Related in: MedlinePlus