Diagnosis of osteomyelitis in neuropathic foot ulcers

被引:26
作者
Crerand, S [1 ]
Dolan, M [1 ]
Laing, P [1 ]
Bird, M [1 ]
Smith, ML [1 ]
Klenerman, I [1 ]
机构
[1] ROYAL LIVERPOOL UNIV HOSP TRUST,LIVERPOOL L69 3BX,MERSEYSIDE,ENGLAND
来源
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME | 1996年 / 78B卷 / 01期
关键词
D O I
10.1302/0301-620X.78B1.0780051
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
We reviewed all patients with a clinically infected foot ulcer attending a specialised neuropathic foot clinic. Neuropathy was confirmed by the inability to feel a 5.07 Semmes-Weinstein hair, areflexia and impaired vibration sense, as measured by a biothesiometer. Of 40 patients who attended the clinic over a two-year period, six with ischaemic ulcers were excluded, The remaining 34 had plain radiographs of the foot followed by a (99)m Tc-MDP bone scan, If the latter was positive, an In-111-labelled WBC scan was performed with planar and/or tomographic dual-isotope studies where appropriate, Bone and WBC scans were performed in 31 patients, In ten, isotope imaging showed infection localised to the soft tissues only and conservative treatment was successful in them all, Eighteen patients were treated surgically with excision of the involved bone, which was sent for culture and histological examination, Dual-isotope scans had a sensitivity of 93% and a specificity of 83%, Tc-99m-MDP bone scans with the appropriate In-111-labelled WBC scans can reliably determine the site and extent of osteomyelitis in the neuropathic diabetic foot.
引用
收藏
页码:51 / 55
页数:5
相关论文
共 25 条
[1]  
Bell J.A., 1978, REHABILITATION HAND, V1st, P273
[2]  
BIRKE JA, 1986, LEPROSY REV, V57, P261
[3]   USE OF A BIOTHESIOMETER TO MEASURE INDIVIDUAL VIBRATION THRESHOLDS AND THEIR VARIATION IN 519 NON-DIABETIC SUBJECTS [J].
BLOOM, S ;
TILL, S ;
SONKSEN, P ;
SMITH, S .
BRITISH MEDICAL JOURNAL, 1984, 288 (6433) :1793-1795
[4]  
BONAKDARPOUR A, 1983, ORTHOP CLIN N AM, V14, P21
[5]  
Brand P., 1983, DIABETIC FOOT, P829
[6]  
Caprioli R, 1986, J Foot Surg, V25, P263
[7]  
EDMONDS ME, 1985, Q J MED, V57, P843
[8]  
EISENBERG B, 1989, Journal of Foot Surgery, V28, P532
[9]   GLUCOSE-INTOLERANCE AND HYPERTENSION IN NORTH LONDON - THE ISLINGTON DIABETES SURVEY [J].
FORREST, RD ;
JACKSON, CA ;
YUDKIN, JS .
DIABETIC MEDICINE, 1986, 3 (04) :338-342
[10]   OSSEOUS LESIONS OF FOOT IN DIABETIC NEUROPATHY [J].
FRIEDMAN, SA ;
RAKOW, RB .
DIABETES, 1971, 20 (05) :302-&