Tawn D J, O'Hare J P, O'Brien I A, Watt I, Dieppe P A, Corrall R J
Department of Radiodiagnosis, Bristol Royal Infirmary.
Br J Radiol. 1988 Apr;61(724):273-9. doi: 10.1259/0007-1285-61-724-273.
Twenty-seven diabetic patients with clinical evidence of neuropathy were investigated by foot radiography, two-phase bone scintigraphy, biothesiometry and cardiovascular autonomic function testing. Typical signs of diabetic osteopathy on radiography were found in 10 subjects (37%), the degree of radiographic abnormality correlating with the severity of neurological impairment. Furthermore, all diabetics with evidence of severe neuropathy showed some evidence of osteopathy on foot radiographs. In all 10 cases of diabetic osteopathy diagnosed radiographically, abnormalities were shown on scintigraphy. In addition, five other patients showed scintigraphic abnormalities, without corresponding changes on radiography, and in this group the neurological impairment was less severe. Although confirmatory longitudinal studies are necessary, it seems likely that the earliest changes of diabetic neuropathic osteopathy may thus be recognized on bone scintigraphy, at a time when conventional radiographs are normal. This stage of diabetic osteopathy is associated with a lesser degree of neurological impairment.
对27例有神经病变临床证据的糖尿病患者进行了足部X线摄影、双期骨闪烁扫描、生物感觉测量和心血管自主神经功能测试。10名受试者（37%）的X线摄影显示有典型的糖尿病性骨病征象，X线异常程度与神经损伤严重程度相关。此外，所有有严重神经病变证据的糖尿病患者足部X线片均显示有骨病迹象。在经X线摄影诊断的10例糖尿病性骨病中，闪烁扫描均显示异常。此外，另有5例患者闪烁扫描显示异常，但X线摄影无相应变化，且该组神经损伤较轻。尽管需要进行验证性纵向研究，但似乎在传统X线片正常时，骨闪烁扫描可能最早识别出糖尿病性神经病变性骨病的变化。糖尿病性骨病的这一阶段与较轻程度的神经损伤有关。
