Kumar S, Kyi M, Wraight P R
Department of Diabetes and Endocrinology, The Royal Melbourne Hospital, Parkville, VIC, Australia.
Diabet Med. 2016 Nov;33(11):e30-e31. doi: 10.1111/dme.13026.
Diabetic foot infections are an important cause of hospitalization, health expenditure and mortality. Bone biopsy is the gold standard for diagnosing diabetic foot osteomyelitis but it is not routinely performed in most centres. Instead, a combination of history, examination, biochemical and radiological findings are used to make the diagnosis.
Here, we report a case mimicking diabetic foot osteomyelitis, where the histology was crucial in acquiring the correct diagnosis.
The absence of ulceration in cases of presumed diabetic foot osteomyelitis should raise suspicion of potential rare mimics of osteomyelitis and bone biopsy should be considered to further evaluate the underlying etiology prior to any definitive surgical management.
糖尿病足感染是住院、医疗支出和死亡的重要原因。骨活检是诊断糖尿病足骨髓炎的金标准，但在大多数中心并非常规进行。相反，结合病史、体格检查、生化和影像学检查结果来做出诊断。
在此，我们报告一例疑似糖尿病足骨髓炎的病例，其中组织学检查对于获得正确诊断至关重要。
在疑似糖尿病足骨髓炎的病例中，若无溃疡应怀疑可能存在罕见的骨髓炎模仿疾病，在进行任何确定性手术治疗之前，应考虑进行骨活检以进一步评估潜在病因。
