Beyond ulcers and osteomyelitis: imaging of less common musculoskeletal complications in diabetes mellitus

Rao, Anuradha; Girish, Gandikota

doi:10.1259/bjr.20170301

Cited by 6 publications

(2 citation statements)

References 44 publications

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“…Infection from diabetic skin ulcers may progress to bone causing osteomyelitis. Joint infection may present following osteomyelitis via spread from the adjacent infected bone, often necessitating amputation for definitive source control 29. A history of bacteremia may have contributed to the risk of C. difficile infection by increasing the duration or breadth of antibiotic exposure.…”

Section: Discussionmentioning

confidence: 99%

Septic Arthritis in the End-Stage Renal Disease Population

Aitkens

Winn

Waller

et al. 2022

Journal of Investigative Medicine

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Septic arthritis is important to consider in any patient who presents with joint pain because it is a medical emergency with an 11% fatality rate. Diagnosis and treatment may improve prognosis; however, many patients do not regain full joint function. In patients with end-stage renal disease (ESRD), immune dysfunction due to uremia and chronic vascular access leads to increased risk of infection. We examined the incidence, risk factors and sequelae of septic arthritis in a cohort of hemodialysis patients. The US Renal Data System was queried for diagnoses of septic arthritis and selected sequelae using International Statistical Classification of Diseases and Related Health Problems-9 and Current Procedural Terminology-4 codes in patients who initiated hemodialysis between 2005 and 2010. Multivariable logistic regression was used to determine potential risk factors for septic arthritis and its sequelae. 7009 cases of septic arthritis were identified, an incidence of 514.8 per 100,000 persons per year. Of these patients, 2179 were diagnosed with a documented organism within 30 days prior to or 14 days after the septic arthritis diagnosis, with methicillin-resistant Staphylococcus aureus infections (57.4%) being the most common. Significant risk factors for septic arthritis included history of joint disease, immune compromise (diabetes, HIV, cirrhosis), bacteremia and urinary tract infection. One of the four sequelae examined (joint replacement, amputation, osteomyelitis, Clostridioides difficile infection) occurred in 25% of septic arthritis cases. The high incidence of septic arthritis and the potential for serious sequelae in patients with ESRD suggest that physicians treating individuals with ESRD and joint pain/inflammation should maintain a high clinical suspicion for septic arthritis.

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Section: Discussionmentioning

confidence: 99%

Septic Arthritis in the End-Stage Renal Disease Population

Aitkens

Winn

Waller

et al. 2022

Journal of Investigative Medicine

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“…Metabolic disorders in diabetes mellitus affect various organ systems [6]. The most frequent and multiple are diseases of the musculoskeletal system as the result of microangiopathy, pathological changes in connective tissue and peripheral nerves associated with chronic hyperglycemia.…”

Section: R E L E V a N C Ementioning

confidence: 99%

A Novel Method for Surgicaltreatment of Osteomyelitis of Distal Phalanx: A Clinical Case

Морозов¹,

Lvovich²,

Minakova³

et al. 2021

ArveMED

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— Background: Osteomyelitis is an infectious-inflammatory destructive bone disease caused by nonspecific and specific microflora, or microbial communities. Diabetes mellitus is the most common pathology associated with osteomyelitis and may be responsible for exacerbation of chronic osteomyelitis. Objective: to demonstrate a new patented technique for surgical treatment of osteomyelitis of distal phalanx (I finger) on the example of a clinical case. Methods: A female patient P. 34 years old, who has type 2 diabetes mellitus, decompensated. Daily glucosometry shows changes in capillary blood glucose from 7 to 25 mmol/L during the last month; the last blood test for HbA1c — 10.4%, it should be noted that the patient adheres to the diet prescribed by the endocrinologist and receives drug therapy according to treatment standards, however, attempts to compensate the disease have been failed. The patient suffers from obesity of 1 degree (BMI = 30.11). Results: Operation: after preparation of the surgical site with Betadin’s solution, local anesthesia according to Oberst-Lukashevich (injection of 3 ml 2% Lidocaine solution on each side into the lateral surfaces of the I finger of the right hand from the place of harness application, proximal to the intervention area) was provided. Extraction of the nail plate with dissection of soft tissues along the phalanx and along the projection of the nail bed and rotation of tissues downwards to expose the bone destruction focus. Then necrectomy of the damaged bone was performed followed by sanitization and returning of soft tissues to their place without suturing. Conclusion: The given example of surgical treatment of finger osteomyelitis has undeniable advantages due to a number of reasons: elimination of traumatization of finger’s working surface, achievement of cosmetic effect, preservation of aesthetic and function of hand, as well as all types of sensitivity of finger skin. It is worth noting that this method of surgical treatment of osteomyelitis has more favorable course of the postoperative period due to a shorter duration of pain syndrome and the general reaction of the body.

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Screening of Foot Inflammation in Diabetic Patients by Noninvasive Imaging Modalities

Mirghani

2020

Diabetic Foot Ulcer

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Beyond ulcers and osteomyelitis: imaging of less common musculoskeletal complications in diabetes mellitus

Cited by 6 publications

References 44 publications

Septic Arthritis in the End-Stage Renal Disease Population

Septic Arthritis in the End-Stage Renal Disease Population

A Novel Method for Surgicaltreatment of Osteomyelitis of Distal Phalanx: A Clinical Case

Screening of Foot Inflammation in Diabetic Patients by Noninvasive Imaging Modalities

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