A comprehensive study of diabetic foot ulcer with special reference to magnetic resonance imaging

Abstract

Background: This pictorial review aims to illustrate the various manifestations of the diabetic foot on magnetic resonance (MR) imaging. The utility of MR imaging and its imaging features in the diagnosis of pedal osteomyelitis are illustrated. There is often difficulty encountered in distinguishing osteomyelitis from neuroarthropathy, both clinically and on imaging. By providing an accurate diagnosis based on imaging, the radiologist plays a significant role in the management of patients with complications of diabetic foot.Methods: This is a prospective and observational study conducted on 50 patients with diabetic foot ulcer admitted in general surgical ward of Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar. Required pathological or biochemical assessments like complete blood count (CBC), fasting blood sugar (FBS), post prandial blood sugar (PPBS), random blood sugar (RBS), hemoglobin A1c (HbA1C), liver function test (LFT), kidney function test (KFT), serum electrolytes and other relevant investigations will be done on admission. Further magnetic resonance imaging (MRI) will be done in radiological investigations and findings will be noted.Results: In the case of early osteomyelitis, the rate and accuracy of detection is at best 50–60%, as the soft tissues are not adequately demonstrated. For the assessment of soft tissue infection and osteomyelitis involving the foot, MRI is the modality of choice.Conclusions: It has been shown that MRI, in combination with radiography, is the most accurate in the detection of diabetic pedal osteomyelitis and its differentiation from neuroarthropathy. Males are more affected than females in case of soft tissue infections and joint complications.