MSCT semiotics of diabetic osteoarthropathy complicated by chronic osteomyelitis

Abstract

Background Conventional radiography, magnetic resonance imaging, nuclear medicine scintigraphy are the imaging techniques currently in use for the evaluation of diabetic neuroosteoarthropathy (DN) with computed tomography being not commonly employed even for cases complicated by chronic osteomyelitis. The objective was to explore MSCT-semiotics of anatomical and radiomorphological changes in foot bones in patients with DN complicated by chronic osteomyelitis (CO) to determine most common manifestations of CO in diabetic foot. Material and methods Single-centre retrospective study. A series of cases. Preoperative radiological findings, MSCT (multislice computed tomography) were examined in 14 patients with DN complicated by chronic osteomyelitis. Results The patients showed impaired structure of the cancellous bone of various severity depending on the nature and localization of foot bone destruction. Overall bone density was higher in cancellous bone of the distal tibia, talus, calcaneus with the local density ranging within significant limits and was maximum at some points of the subchondral tibia and talus and minimum in the intertrabecular areas of the calcaneus and the distal tibia. MSCT scans showed medial calcinosis of the arteries in 5 (35.7 %) from 14 patients. Conclusion MSCT as one of the most objective method for the qualitative and quantitative assessment of the bone is practical for identifying anatomical and topographic relationships of the foot bones and the ankle joint to facilitate reconstructions in three planes and VRT, which is important for assessing the foot in patients with DN complicated by chronic osteomyelitis. The technique allows measurement of the foot bone density in Hounsfield units determining the severity of osteoporosis, the extent of architectonics impairment to facilitate preoperative planning.