Ertugrul M B, Baktiroglu S, Salman S, Unal S, Aksoy M, Berberoglu K, Calangu S
Department of Infectious Diseases and Clinical Microbiology, Adnan Menderes University Medical Faculty, Aydin, Turkey.
Diabet Med. 2006 Jun;23(6):649-53. doi: 10.1111/j.1464-5491.2006.01887.x.
Foot infections and their sequelae are among the most common and severe complications of diabetes mellitus. As diabetic patients with foot infections develop osteomyelitis and may progress to amputation, early diagnosis of osteomyelitis is critical.
We compared the diagnostic values of labelled leucocyte scanning with Tc(99)m, magnetic resonance imaging (MRI) and microbiological examination of bone tissue specimens with histopathology, the definitive diagnostic procedure. Thirty-one diabetic patients with foot lesions were enrolled in the study and histopathological examination was performed in all. Patients had clinically suspected foot lesions of > or = grade 3 according to the classification of Wagner.
Bone specimens were obtained for histopathological examination. Microbiology had a sensitivity of 92% and specificity of 60%. Labelled leucocyte scanning had a sensitivity of 91%, specificity of 67%, and MRI a sensitivity of 78%, specificity of 60%.
Microbiological examination may be as useful as and less costly than other diagnostic procedures and is the only method which can guide the choice of antibiotic therapy.
足部感染及其后遗症是糖尿病最常见且最严重的并发症之一。由于患有足部感染的糖尿病患者会发展为骨髓炎并可能进展至截肢，因此骨髓炎的早期诊断至关重要。
我们将锝（99）m标记白细胞扫描、磁共振成像（MRI）以及骨组织标本微生物学检查与组织病理学（确诊诊断程序）的诊断价值进行了比较。31例患有足部病变的糖尿病患者纳入本研究，全部进行了组织病理学检查。根据瓦格纳分类法，患者临床上怀疑足部病变≥3级。
获取骨标本进行组织病理学检查。微生物学检查的敏感性为92%，特异性为60%。标记白细胞扫描的敏感性为91%，特异性为67%，MRI的敏感性为78%，特异性为60%。
微生物学检查可能与其他诊断程序一样有用且成本更低，并且是唯一能够指导抗生素治疗选择的方法。
