Berendt Anthony R, Lipsky Benjamin
Bone Infection Unit, Nuffield Orthopaedic Centre, Headington, Oxford, UK.
Curr Diab Rep. 2004 Dec;4(6):424-9. doi: 10.1007/s11892-004-0051-3.
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.
骨髓炎（骨感染）和神经骨关节病（夏科关节病）是糖尿病神经病变的肢体威胁性并发症，治疗方法截然不同。区分它们可能很困难，但却很重要。在夏科关节病中，非感染性软组织炎症伴随着快速进展的破坏，首先是关节，然后是骨骼。这种情况发生在血管丰富、严重神经病变但未发生溃疡的足部。在骨髓炎中，慢性软组织溃疡先于骨骼感染，骨骼可能已暴露在外。如果具备足够的技术和解读能力，磁共振成像和骨活检是首选的诊断检查。
