Gureh Monika, Attri Ashok Kumar, Gupta Sanjay, Kaur Jasbinder, Jain Mantu
Department of General Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Department of Biochemistry, Government Medical College and Hospital, Chandigarh, India.
J Orthop Case Rep. 2025 Sep;15(9):342-347. doi: 10.13107/jocr.2025.v15.i09.6120.
Foot ulcer is one of the common problems in patients with diabetes mellitus. The spectrum of diabetic foot infection is wide, ranging from cellulitis and soft tissue infection to osteomyelitis (OM). OM requires further testing and investigations and even longer treatments. The aim of this prospective study was to assess the performance of serum markers, namely, the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and procalcitonin (PCT) in the diagnosis and follow-up of patients with diabetic foot osteomyelitis (DFO) and to find correlation between serum levels of these biomarkers and treatment response.
This prospective study was carried out in 50 patients. Diagnosis of OM was made by clinical examination and confirmed by radiological studies. The serum levels of ESR, CRP, and PCT were determined on admission in all the patients and then on day 15 and day 30 in the osteomyelitic group.
No significant difference was observed in the levels of ESR, CRP, and PCT in DFO and non-OM patients (P > 0.05) at presentation. However, there was a significant difference (P > 0.05) in levels of these markers between patients with healed and non-healed lesions in the osteomyelitic group on day 15 and day 30.
Biomarkers may not help in diagnosing OM. However, the level of biomarkers decreases significantly in response to treatment validating their role in predicting healing.
足部溃疡是糖尿病患者常见的问题之一。糖尿病足感染范围广泛，从蜂窝织炎和软组织感染到骨髓炎（OM）。骨髓炎需要进一步检查和调查，甚至需要更长时间的治疗。这项前瞻性研究的目的是评估血清标志物，即红细胞沉降率（ESR）、C反应蛋白（CRP）和降钙素原（PCT）在糖尿病足骨髓炎（DFO）患者诊断和随访中的表现，并找出这些生物标志物的血清水平与治疗反应之间的相关性。
这项前瞻性研究对50名患者进行。通过临床检查诊断骨髓炎，并通过放射学研究进行确认。在所有患者入院时测定ESR、CRP和PCT的血清水平，然后在骨髓炎组的第15天和第30天再次测定。
在就诊时，DFO患者和非骨髓炎患者的ESR、CRP和PCT水平无显著差异（P>0.05）。然而，在第15天和第30天，骨髓炎组中病变愈合和未愈合的患者之间，这些标志物的水平存在显著差异（P>0.05）。
生物标志物可能无助于诊断骨髓炎。然而，生物标志物的水平在治疗后显著下降，这证实了它们在预测愈合方面的作用。
