Diabetic foot infections are associated with significant morbidity, account for the largest number of diabetes-related hospital bed days and contribute to 50% of all lower extremity amputations in the United States.
Initial procedure for imaging suspected osteomyelitis in the diabetic patient.
Characteristic signs of osteomyelitis on plain radiograph include focal loss of trabecular pattern, periosteal reaction and frank bone destruction.
Plain radiographs can also reveal presence of foreign bodies, gas in soft tissues, fractures or bony abnormalities.
Poor sensitivity (22-75%) as osteomyelytic changes are delayed for 10-21 days following infection.
30-50% loss of bone density is required before a radiograph will demonstrate osteomyelitis.
False positive results may be found in patients with neuroarthropathy (Charcots arthropathy).