Diabetes Revealed: Multisystem Danger

Abstract

Diabetic patients present a challenging population for the performance of various imaging studies and special considerations need to be made to obtain adequate studies. Imaging plays a significant role in assessing the multisystem morbidity of diabetes. Furthermore, diabetes in women may have some unique features and consequences and imaging studies can aid in the correct management of these patients.

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

“…36 MRI is the investigation of choice (sensitivity of 90% and specificity of 83%) for detecting foot osteomyelitis and soft-tissue infection. 37 STIR is the most sensitive imaging modality for diagnosis, with marrow hyperintensity on STIR corresponding to T 1 hypointensity. STIR hyperintensity without significant T 1 hypointensity may just represent edematous changes due to hyperemia related to soft tissue infection.…”

“…Multiple bone and joint involvement, periarticular and subchondral predilection, overlying intact skin, the absence of ulcers and sinus tracts favor the diagnosis of Charcot's neuropathic joint rather than osteomyelitis. 37 In chronic arthropathy, differentiation is easy given the paucity of marrow edema; however, the disappearance of previously seen subchondral cysts or of intra-articular bodies in patients with neuroarthropathy indicates a superimposed infection. 37 Another feature noted by Ahmedi et al 39 is that frequency of intraarticular loose bodies are less in infected neuropathic joint, probably attributed to the dissolution of these bodies after infection sets in, or that their signal intensity may change to the fluid signal due to the surrounding edema and they get obscured.…”

Sonographic Findings of Common Musculoskeletal Diseases in Patients with Diabetes Mellitus

“…Vascular evaluation is important for assessment of healing potential of diabetic foot. So, vascular Doppler sonography of extremities is a commonly used and feasible diagnostic tool for evaluating general vascular conditions (anatomy, physiology) in diabetic patients with nonspecific peripheral symptoms ( 13 ).…”