3-phase Bone Scan Foot There is no relevant literature to support the use of a 3-phase bone scan as the initial screening examination in diabetic patients with suspected osteomyelitis of the foot. US Foot There is no relevant literature to support the use of ultrasound (US) as the initial screening examination in diabetic patients with suspected osteomyelitis of the foot. 3-phase Bone Scan and WBC Scan with SPECT or SPECT/CT foot There is no relevant literature to support the use of single-photon emission computed tomography (SPECT/CT) as the initial screening examination in diabetic patients with suspected osteomyelitis of the foot. Variant 2: Soft-tissue swelling without ulcer. Suspected osteomyelitis or early neuropathic arthropathy changes of the foot in patients with diabetes mellitus. Additional imaging following radiographs. The likelihood of developing osteomyelitis without an associated wound or ulceration is extremely low. Almost all osteomyelitis and soft-tissue abscesses of the diabetic foot represent areas of contiguous infection from adjacent skin ulcerations and not hematogenous seeding [14]. Any imaging modality performed for this variant should be able to identify soft-tissue infections, tumors and abscesses, early neuropathic arthropathy, or subtle fractures not revealed on initial radiographs. Diabetic foot osteomyelitis and neuroarthropathy can be difficult to differentiate clinically. The early diagnosis of neuropathic disease prior to the development of radiographic change is important, as these patients will be treated with altered footwear and orthotics to prevent the progression to deformity. US Foot US is of limited benefit in the detection of adult osteomyelitis because of its inability to penetrate the cortex of the bone. The role of US in the diabetic foot includes detection of subperiosteal and soft-tissue abscesses, tenosynovitis, joint effusions, and radiolucent foreign bodies.
Suspected Osteomyelitis of the Foot in Patients with Diabetes Mellitus. 3-phase Bone Scan Foot There is no relevant literature to support the use of a 3-phase bone scan as the initial screening examination in diabetic patients with suspected osteomyelitis of the foot. US Foot There is no relevant literature to support the use of ultrasound (US) as the initial screening examination in diabetic patients with suspected osteomyelitis of the foot. 3-phase Bone Scan and WBC Scan with SPECT or SPECT/CT foot There is no relevant literature to support the use of single-photon emission computed tomography (SPECT/CT) as the initial screening examination in diabetic patients with suspected osteomyelitis of the foot. Variant 2: Soft-tissue swelling without ulcer. Suspected osteomyelitis or early neuropathic arthropathy changes of the foot in patients with diabetes mellitus. Additional imaging following radiographs. The likelihood of developing osteomyelitis without an associated wound or ulceration is extremely low. Almost all osteomyelitis and soft-tissue abscesses of the diabetic foot represent areas of contiguous infection from adjacent skin ulcerations and not hematogenous seeding [14]. Any imaging modality performed for this variant should be able to identify soft-tissue infections, tumors and abscesses, early neuropathic arthropathy, or subtle fractures not revealed on initial radiographs. Diabetic foot osteomyelitis and neuroarthropathy can be difficult to differentiate clinically. The early diagnosis of neuropathic disease prior to the development of radiographic change is important, as these patients will be treated with altered footwear and orthotics to prevent the progression to deformity. US Foot US is of limited benefit in the detection of adult osteomyelitis because of its inability to penetrate the cortex of the bone. The role of US in the diabetic foot includes detection of subperiosteal and soft-tissue abscesses, tenosynovitis, joint effusions, and radiolucent foreign bodies.