Document Detail

Efficacy of three-phase bone scans in evaluating diabetic foot ulcers.
MedLine Citation:
PMID:  10395336     Owner:  NLM     Status:  MEDLINE    
To evaluate the utility of bone scans in determining the treatment of diabetic patients with foot ulcers, a retrospective study was conducted. Medical records were reviewed for clinical signs of infection, laboratory data, and the radiologists' interpretations of imaging studies. During the study period, 34 bone scans were obtained by the treating physicians to evaluate diabetic foot ulcers. Among these, 22 of 34 bone scans were markedly confirmatory of being "consistent with osteomyelitis," 8 of 34 were moderately confirmatory ("indeterminate with regard to osteomyelitis"), and 4 of 34 were not confirmatory ("not consistent with osteomyelitis"). Of the 22 patients in the markedly confirmatory group, eight patients with clinical findings of uncontrolled infection or gangrene were treated with partial or complete amputation, whereas all others (14 patients) were treated with local wound care+/-intravenous antibiotics. Among the eight bone scans interpreted as indeterminate, three patients required partial or complete amputation, whereas the other five patients were managed with local wound care. Of the four patients with nonconfirmatory bone scans, two patients had evidence of dry gangrene and required amputation, whereas the other two patients did not have clinical evidence of infection or gangrene and were treated with local wound care. There was no significant difference in the amputation rate for patients with confirmatory, indeterminate, or nonconfirmatory bone scans for osteomyelitis (36%, 37%, and 50%, respectively) (P > 0.5). Therefore, the authors concluded that the ultimate treatment should be based on clinical indicators of the presence of uncontrolled infection or gangrene rather than on bone scan findings.
P R Jay; J D Michelson; M S Mizel; D Magid; T Le
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Foot & ankle international     Volume:  20     ISSN:  1071-1007     ISO Abbreviation:  Foot Ankle Int     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-08-05     Completed Date:  1999-08-05     Revised Date:  2014-08-27    
Medline Journal Info:
Nlm Unique ID:  9433869     Medline TA:  Foot Ankle Int     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  347-55     Citation Subset:  IM    
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MeSH Terms
Diabetic Foot / complications,  pathology,  radionuclide imaging*,  therapy*
Middle Aged
Osteomyelitis / diagnosis,  etiology,  radionuclide imaging*
Predictive Value of Tests
Radionuclide Imaging / methods,  standards
Retrospective Studies
Technetium / diagnostic use
Treatment Outcome
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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