The effects of peripheral vascular disease with osteomyelitis in the diabetic foot

Hill, Stephen L.; Holtzman, Golde I.; Buse, Roxanne

doi:10.1016/s0002-9610(99)00050-1

Cited by 56 publications

(41 citation statements)

References 17 publications

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“…Most ulcers in our patient group that were clinically suggestive of osteomyelitis were seen around the fifth and first metatarsal heads and the distal phalanx of the great toe. Ulceration below the first metatarsophalangeal joint is commonly cited to be the most frequent location in the feet of diabetic patients (21) and often results from deformity (eg, hallux valgus) and limited mobility of the first metatarsophalangeal joint (22,23). Ulceration around the fifth metatarsophalangeal joint was reported in only a minority of ambulatory patients (16), however, or was equal in frequency to the occurrence of ulcers below the second to fourth metatarsal heads in another study (23).…”

Section: Discussionmentioning

confidence: 94%

MR Image Analysis of Pedal Osteomyelitis: Distribution, Patterns of Spread, and Frequency of Associated Ulceration and Septic Arthritis

Ledermann¹,

Morrison²,

Schweitzer³

2002

Radiology

140

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Section: Discussionmentioning

confidence: 94%

MR Image Analysis of Pedal Osteomyelitis: Distribution, Patterns of Spread, and Frequency of Associated Ulceration and Septic Arthritis

Ledermann¹,

Morrison²,

Schweitzer³

2002

Radiology

140

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“…Use of MRI may improve outcome by better defining the extent of both soft tissue and bone involvement [64]. In patients with critical limb ischemia, clinicians must also consider early revascularization [3].…”

Section: Combined Approachmentioning

confidence: 99%

Controversies in Diagnosing and Managing Osteomyelitis of the Foot in Diabetes

Jeffcoate

Lipsky

2004

Clinical Infectious Diseases

214

145

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The optimal approach to diagnosing and managing osteomyelitis of the foot in diabetes is unclear. Diagnosis is based on clinical signs, supplemented by a variety of imaging tests. Bone biopsy is the accepted criterion standard for diagnosis but is not used by many. Management traditionally involves surgical removal of infected bone, combined with antibiotic therapy. However, recent studies have shown that antibiotics alone may apparently eliminate bone infection in many cases. There is also evidence that early amputation of infected digits is frequently noncurative. Agreement on criteria for diagnosing osteomyelitis is required, and randomized trials are urgently needed, to determine the relative benefits of various surgical interventions and the optimal deployment of antibiotics. We review the microbiology of osteomyelitis of the foot in diabetes, the benefits and limitations of various diagnostic procedures, and the evidence for the effectiveness of both surgical and nonsurgical approaches to management.

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“…The bone infection may also progress, resulting in necrosis, secondary abscess formation, and extension into soft tissue, fascial planes, and foot compartments. This may eventuate in serious systemic illness, excessive soft tissue loss or compromise to the mechanics of the foot, any of which may make amputation the only option [36]. Diagnosing osteomyelitis in the diabetic foot poses special challenges not commonly encountered with other manifestations of bone infection [37].…”

Section: Diagnosing Osteomyelitis In the Diabetic Footmentioning

confidence: 99%

Diagnosing and treating diabetic foot infections

Lipsky

Berendt

Embil

et al. 2004

Diabetes Metab. Res. Rev.

112

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Foot infections are a common, complex and costly complication of diabetes. We have made considerable progress in establishing consensus definitions for defining infection. Similarly, we have learned much about the appropriate ways to diagnose both soft tissue and bone infections. Accompanying these advances have been improvements in our knowledge of the proper approaches to antibiotic (and surgical) therapy for diabetic foot infections. Furthermore, investigators have explored the value of various adjunctive therapies, especially granulocyte colony stimulating factors and hyperbaric oxygen, for improving outcomes. This paper presents a summary of a minisymposium on infection of the diabetic foot that was held at the fourth International Symposium on the Diabetic Foot, in Noordwijkerhout, The Netherlands.

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The effects of peripheral vascular disease with osteomyelitis in the diabetic foot

Cited by 56 publications

References 17 publications

MR Image Analysis of Pedal Osteomyelitis: Distribution, Patterns of Spread, and Frequency of Associated Ulceration and Septic Arthritis

MR Image Analysis of Pedal Osteomyelitis: Distribution, Patterns of Spread, and Frequency of Associated Ulceration and Septic Arthritis

Controversies in Diagnosing and Managing Osteomyelitis of the Foot in Diabetes

Diagnosing and treating diabetic foot infections

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