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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Ultrason
2018 ; 18
(72
): 42-49
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Diabetic foot syndrome: Charcot arthropathy or osteomyelitis? Part I: Clinical
picture and radiography
#MMPMID29844940
Konarzewska A
; Korzon-Burakowska A
; Rzepecka-Wejs L
; Sudo?-Szopi?ska I
; Szurowska E
; Studniarek M
J Ultrason
2018[Mar]; 18
(72
): 42-49
PMID29844940
show ga
One of significant challenges faced by diabetologists, surgeons and orthopedists
who care for patients with diabetic foot syndrome is early diagnosis and
differentiation of bone structure abnormalities typical of these patients, i.e.
osteitis and Charcot arthropathy. In addition to clinical examination, the
patient's medical history and laboratory tests, imaging plays a significant role.
The evaluation usually begins with conventional radiographs. In the case of
osteomyelitis, radiography shows osteopenia, lytic lesions, cortical destruction,
periosteal reactions as well as, in the chronic phase, osteosclerosis and
sequestra. Neurogenic arthropathy, however, presents an image resembling rapidly
progressing osteoarthritis combined with aseptic necrosis or inflammation. The
image includes: bone destruction with subluxations and dislocations as well as
pathological fractures that lead to the presence of bone debris, osteopenia and,
in the later phase, osteosclerosis, joint space narrowing, periosteal reactions,
grotesque osteophytes and bone ankylosis. In the case of an unfavorable course of
the disease and improper or delayed treatment, progression of these changes may
lead to significant foot deformity that might resemble a "bag of bones".
Unfortunately, radiography is non-specific and frequently does not warrant an
unambiguous diagnosis, particularly in the initial phase preceding bone
destruction. For these reasons, alternative imaging methods, such as magnetic
resonance tomography, scintigraphy, computed tomography and ultrasonography, are
also indicated.
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