[ Diabetes Type 1 ]

99mTc-nanocolloid scintigraphy for assessing osteomyelitis in diabetic neuropathic feet. – PubMed


The optimal way to manage diabetic foot osteomyelitis remains uncertain, with debate in the literature as to whether it should be managed conservatively (ie, nonsurgically) or surgically. Operative facilities and home intravenous antibiotic therapy programs may not be available in remote or rural communities. Twenty-nine plain radiographs, 20 bone scans, and 30 MR studies were obtained in 24 patients. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor alpha (TNFα), monocyte chemotactic protein-1 (MCP-1) and macrophage inflammatory protein-1 alpha (MIP1α) were measured at baseline after 3 and 6 weeks of standard therapy. A plain film is obtained and shown below. The method utilizes two different colored QDs (i.e., red and green). It causes disease by the following mechanisms: (1) decreased pedal sensation that leads to undetected mechanical and thermal injuries, (2) excessive and repetitive pressure on plantar bony prominences, especially the metatarsal heads, (3) gait disturbances and foot deformities (eg, hammer toes, claw toes) that increase focal pressure, and (4) autonomic neuropathy that leads to decreased sweating and dry, cracked skin.5,6 (Reference) Other factors include peripheral vascular disease, peripheral motor neuropathy, and defects in immunity and wound healing.

Patients with DFO had a higher erythrocyte sedimentation rate (85 vs 71, P = .02) than patients with STI, however the differences in C-reactive protein (13.4 vs 11.8, P = .29) were not significantly different. Osteomyelitis located in the first metatarsal joint was less likely to heal by the eighth week (OR = 0.4, 95% CI = 0.2-0.9, P = .037) and 12th week (OR = 0.4, 95% CI = 0.2-1.0, P = .040). Terms Related to the Moving Wall Fixed walls: Journals with no new volumes being added to the archive. Therefore, when “cure” is reported we really cannot be sure if soft tissue infection was cured or if bone infection was indeed cured.

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