Plain Radiography for Diagnosing and Monitoring Foot Osteomyelitis in Persons With Diabetes: Accuracy, Limitations and Clinical Utility
Henry S. G. Harrison, Edgar J. G. Peters, Mario Maas, Lawrence A. Lavery, Kerensa M. Beekman
TL;DR
This paper reviews how well plain X-rays can detect and monitor foot bone infections in diabetic patients, comparing single and repeated X-rays.
Contribution
The study systematically compares the diagnostic accuracy of singular versus serial plain radiography for diabetic foot osteomyelitis.
Findings
Sensitivity of singular radiography ranged from 22% to 93%, and specificity from 22% to 94%.
Serial radiography showed a sensitivity of 89% but lower specificity of 38%.
Serial radiography outperformed singular radiography in sensitivity in three studies but not in specificity.
Abstract
Osteomyelitis of the feet is common in persons living with diabetes due to peripheral artery disease, peripheral neuropathy, and increased susceptibility to infection. Although plain radiography is a low‐cost and widely available diagnostic tool, its diagnostic performance is limited. Serial radiography may improve the accuracy and clinical utility. This systematic review studies the diagnostic accuracy, limitations, and clinical utility of singular versus serial plain radiography for diagnosing osteomyelitis in the foot in persons with diabetes at diagnosis and follow‐up. We conducted PubMed and Embase searches for articles on the diagnostic performance of serial plain radiography for osteomyelitis of the foot in patients with diabetes. Multiple z‐tests were used to compare the performance of singular and serial radiographs. Fourteen studies were included, with only one providing…
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Taxonomy
TopicsDiabetic Foot Ulcer Assessment and Management · Peripheral Artery Disease Management · Orthopedic Infections and Treatments