系列X线片在诊断糖尿病足骨骨髓炎中的作用
The Role of Serial Radiographs in Diagnosing Diabetic Foot Bone Osteomyelitis.
作者信息
Leone Antonio, Bianco Nicola Carlo, D'Ambra Giulia, Lucchesi Salvatore, La Rosa Elisa, Infante Amato, Perla Daniele, Gullì Consolato
机构信息
Department of Radiological and Hematological Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli 1, 00168 Rome, Italy.
Department of Radiological and Hematological Sciences, Università Cattolica del Sacro Cuore, Largo A. Gemelli 1, 00168 Rome, Italy.
出版信息
Mediterr J Hematol Infect Dis. 2022 Jul 1;14(1):e2022055. doi: 10.4084/MJHID.2022.055. eCollection 2022.
BACKGROUND AND OBJECTIVE
Diagnosing diabetes-related foot osteomyelitis is sometimes a challenge for clinicians since it may occur without local or systemic signs of infection. Thus, the primary purpose of this article was to evaluate the role of progressive radiographic changes in diagnosing diabetic foot osteomyelitis.
MATERIALS AND METHODS
A retrospective review of databases of our Institution was performed to identify all long-standing diabetic foot patients who underwent two radiographic examinations spaced no more than five weeks apart and a subsequent magnetic resonance (MR) examination from November 2015 to November 2020. A total of 46 patients (32 men, 14 women; mean age, 57.3 years) were identified.
RESULTS
serial radiographs showed 89% sensitivity, 38% specificity, 80% diagnostic accuracy, 87% positive predictive value (PPV), 43% negative predictive value (NPV) to diagnose osteomyelitis (P value < 0,05). Bone destruction was the most reliable radiographic sign with 89% sensitivity, 88% specificity, 89% diagnostic accuracy, 97% PPV, 64% NPV (P value < 0,05).
CONCLUSION
Progressive bony changes detected by serial radiographs are a useful tool to diagnose diabetic foot osteomyelitis.
背景与目的
诊断糖尿病相关足部骨髓炎有时对临床医生而言是一项挑战，因为其可能在无局部或全身感染迹象的情况下发生。因此，本文的主要目的是评估渐进性影像学改变在诊断糖尿病足骨髓炎中的作用。
材料与方法
对本机构数据库进行回顾性分析，以确定2015年11月至2020年11月期间所有接受了间隔不超过五周的两次影像学检查以及随后的磁共振（MR）检查的长期糖尿病足患者。共确定了46例患者（32例男性，14例女性；平均年龄57.3岁）。
结果
系列X线片诊断骨髓炎的敏感性为89%，特异性为38%，诊断准确性为80%，阳性预测值（PPV）为87%，阴性预测值（NPV）为43%（P值<0.05）。骨质破坏是最可靠的影像学征象，敏感性为89%，特异性为88%，诊断准确性为89%，PPV为97%，NPV为64%（P值<0.05）。
结论
系列X线片检测到的渐进性骨质改变是诊断糖尿病足骨髓炎的有用工具。
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