Is this bone infected or not? Differentiating neuro-osteoarthropathy from osteomyelitis in the diabetic foot

被引：46

作者：

Berendt A.R. ^{[1
]}

Lipsky B. ^{[1
]}

机构：

[1] Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford OX3 7LD, Windmill Road, Headington

来源：

Current Diabetes Reports | 2004年 / 4卷 / 6期

关键词：

Osteomyelitis; Soft Tissue Infection; Bone Biopsy; Bone Infection; Charcot Arthropathy;

D O I：

10.1007/s11892-004-0051-3

中图分类号：

学科分类号：

摘要：

Osteomyelitis (bone infection) and neuro-osteoarthropathy (Charcot arthropathy) are limb-threatening complications of diabetic neuropathy with very different therapies. Distinguishing between them may be difficult, but it is important. In Charcot arthropathy, noninfectious soft tissue inflammation accompanies rapidly progressive destruction, first of joints, then of bone. This occurs in a well-vascularized and severely neuropathic, but nonulcerated, foot. In osteomyelitis, chronic soft tissue ulceration precedes infection of bone, which may be physically exposed. Magnetic resonance imaging and bone biopsy are the preferred diagnostic tests, provided adequate technical and interpretive skills are available. Copyright © 2004 by Current Science Inc.

引用

页码：424 / 429

页数：5

共 59 条

[1]

Hart T.J., Healey K., Diabetic osteoarthropathy versus diabetic osteomyelitis, J. Foot Surg., 25, pp. 464-468, (1986)

[2]

Charcot foot: Differentiating this disorder from osteomyelitis, Clin. Diabetes, 10, (1992)

[3]

Lipsky B.A., Osteomyelitis of the foot in diabetic patients, Clin. Infect. Dis., 25, pp. 1318-1326, (1997)

[4]

Embil J.M., The management of diabetic foot osteomyelitis, Diabetic Foot, 3, pp. 76-84, (2000)

[5]

Jones E.A., Manaster B.J., May D.A., Disler D.G., Neuropathic osteoarthropathy: Diagnostic dilemmas and differential diagnosis, Radiographics, 20, (2000)

[6]

Bonham P., A critical review of the literature: Part 1: Diagnosing osteomyelitis in patients with diabetes and foot ulcers, J. Wound Ostomy Continence Nurs., 28, pp. 73-88, (2001)

[7]

Bonham P., A critical review of the literature: Part 2: Antibiotic treatment of osteomyelitis in patients with diabetes and foot ulcers, J. Wound Ostomy Continence Nurs., 28, pp. 141-149, (2001)

[8]

Jeffcoate W.J., Lipsky B.A., Controversies in diagnosing and managing osteomyelitis of the foot in diabetes, Clin. Infect. Dis., 39, SUPPL. 2, (2004)

[9]

Bild D.E., Selby J.V., Sinnock P., Et al., Lower-extremity amputation in people with diabetes. Epidemiology and prevention, Diabetes Care, 12, pp. 24-31, (1989)

[10]

Reiber G.E., Pecoraro R.E., Koepsell T.D., Risk factors for amputation in patients with diabetes mellitus. A case-control study, Ann. Intern. Med., 117, pp. 97-105, (1992)

← 1 2 3 4 5 6 →