Newman L G
Division of Endocrinology and Metabolism, Mount Sinai Medical Center, New York, New York, USA.
Clin Podiatr Med Surg. 1995 Jan;12(1):75-86.
Osteomyelitis underlies the majority of diabetic foot ulcers, and it is usually not detected clinically. Leukocyte scanning with indium oxyquinoline has greater sensitivity than radiographs, bone scans, and MR imaging in diagnosing osteomyelitis in diabetic foot ulcers. All ulcers that expose bone, and perhaps moderately deep ulcers as well, should be treated for osteomyelitis because of the high prevalence of this infection (100% and 82%, respectively). Osteomyelitis should be evaluated for in shallow ulcers by radiographs, followed by leukocyte scans if the former tests are negative. Bone biopsies should be performed if possible because cultures may guide antibiotic treatment.
骨髓炎是大多数糖尿病足溃疡的潜在病因，且通常无法通过临床检查发现。与X线片、骨扫描及磁共振成像相比，使用喹碘方铟进行白细胞扫描在诊断糖尿病足溃疡骨髓炎方面具有更高的敏感性。所有暴露骨质的溃疡，可能还有中度深度的溃疡，均应针对骨髓炎进行治疗，因为这种感染的发生率很高（分别为100%和82%）。对于浅表溃疡，应先通过X线片评估是否存在骨髓炎，若前者检查结果为阴性，则接着进行白细胞扫描。如有可能，应进行骨活检，因为培养结果可指导抗生素治疗。
