Articles | Volume 10, issue 5
https://doi.org/10.5194/jbji-10-411-2025
https://doi.org/10.5194/jbji-10-411-2025
Original full-length article
 | 
29 Oct 2025
Original full-length article |  | 29 Oct 2025

Diagnostic value of magnetic resonance imaging and the outcomes of medical therapy in histologically confirmed diabetes-related foot osteomyelitis

Abhay Mishra, Paige Lyell, and David M. Bamberger

Cited articles

Alaia, E. F., Chhabra, A., Simpfendorfer, C. S., Cohen, M., Mintz, D. N., Vossen, J. A., Zoga, A. C., Fritz, J., Spritzer, C. E., Armstrong, D. G., and Morrison, W. B.: MRI nomenclature for musculoskeletal infection, Skeletal. Radiol., 50, 2319–2347, https://doi.org/10.1007/s00256-021-03807-7, 2021. 
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Bamberger, D. M., Daus, G. P., and Gerding, D. N.: Osteomyelitis in the feet of diabetic patients: long-term results, prognostic factors, and the role of antimicrobial and surgical therapy, Am. J. Med., 83, 653–660, https://doi.org/10.1016/0002-9343(87)90894-1, 1987. 
Basu, S., Chryssikos, T., Houseni, M., Malay, D. S., Shah, J., Zhuang, H., and Alavi, A.: Potential role of FDG PET in the setting of diabetic neuro-osteoarthropathy: can it differentiate uncomplicated Charcot's neuroarthropathy from osteomyelitis and soft-tissue infection?, Nucl. Med. Commun., 28, 465–472, https://doi.org/10.1097/MNM.0b013e328174447f, 2007. 
Berendt, A. R., Peters, E. J. G., Bakker, K., Embil, J. M., Eneroth, M., Hinchliffe, R. J., Jeffcoate, W. J., Lipsky, B. A., Senneville, E., Teh, J., and Valk, G. D.: Diabetic foot osteomyelitis: a progress report on diagnosis and a systematic review of treatment, Diabetes-Metab. Res., 24, S145–S61, https://doi.org/10.1002/dmrr.836, 2008. 
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Short summary
Guidelines currently recommend magnetic resonance imaging as a preferred imaging modality in the diagnosis of diabetic foot osteomyelitis.  We have found that among histologically confirmed cases the positive predictive value of the test is low, questioning its role in disease confirmation.  Additionally, we have found that the majority of cases of diabetic foot osteomyelitis can be successfully treated medically, even amongst histologically confirmed cases. 
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