Leukocyte scanning with 111In is superior to magnetic resonance imaging in diagnosis of clinically unsuspected osteomyelitis in diabetic foot ulcers

Lisa G. Newman, John Waller, Christopher J. Palestro, George Hermann, Michael J. Klein, Myron Schwartz, Elizabeth Harrington, Martin Harrington, Sheila H. Roman, Alex Stagnaro-Green

Research output: Contribution to journalArticle

Abstract

OBJECTIVE - To compare the accuracies of MRI and leukocyte scanning in diagnosing clinically unsuspected osteomyelitis in diabetic foot ulcers. RESEARCH DESIGN AND METHODS - A prospective study of 16 diabetic foot ulcers in 12 patients, including both ambulatory and hospitalized patients, was performed at a university medical center. Pedal images were obtained by leukocyte scanning with [111In]oxyquinoline and MRI. Definitive diagnosis of osteomyelitis then was determined by bone biopsy for culture and histology. RESULTS - Biopsy-proven osteomyelitis was present in 7 (44%) of the 16 foot ulcers. The diagnosis was suspected clinically in 0%. Leukocyte scanning was 100% sensitive, whereas MRI was only 29% sensitive in diagnosing osteomyelitis in diabetic foot ulcers. Specificities were 67 and 78%, respectively. The positive and negative predictive values (70 and 100%, respectively) for the leukocyte scan also were greater than those of MRI (50 and 58%, respectively). CONCLUSIONS - Leukocyte scanning is superior to MRI in detecting clinically unsuspected osteomyelitis in diabetic foot ulcers.

Original languageEnglish (US)
Pages (from-to)1527-1530
Number of pages4
JournalDiabetes Care
Volume15
Issue number11
StatePublished - Nov 1992
Externally publishedYes

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Diabetic Foot
Osteomyelitis
Leukocytes
Magnetic Resonance Imaging
Foot Ulcer
Oxyquinoline
Biopsy
Foot
Histology
Research Design
Prospective Studies
Bone and Bones

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Newman, L. G., Waller, J., Palestro, C. J., Hermann, G., Klein, M. J., Schwartz, M., ... Stagnaro-Green, A. (1992). Leukocyte scanning with 111In is superior to magnetic resonance imaging in diagnosis of clinically unsuspected osteomyelitis in diabetic foot ulcers. Diabetes Care, 15(11), 1527-1530.

Leukocyte scanning with 111In is superior to magnetic resonance imaging in diagnosis of clinically unsuspected osteomyelitis in diabetic foot ulcers. / Newman, Lisa G.; Waller, John; Palestro, Christopher J.; Hermann, George; Klein, Michael J.; Schwartz, Myron; Harrington, Elizabeth; Harrington, Martin; Roman, Sheila H.; Stagnaro-Green, Alex.

In: Diabetes Care, Vol. 15, No. 11, 11.1992, p. 1527-1530.

Research output: Contribution to journalArticle

Newman, LG, Waller, J, Palestro, CJ, Hermann, G, Klein, MJ, Schwartz, M, Harrington, E, Harrington, M, Roman, SH & Stagnaro-Green, A 1992, 'Leukocyte scanning with 111In is superior to magnetic resonance imaging in diagnosis of clinically unsuspected osteomyelitis in diabetic foot ulcers', Diabetes Care, vol. 15, no. 11, pp. 1527-1530.
Newman, Lisa G. ; Waller, John ; Palestro, Christopher J. ; Hermann, George ; Klein, Michael J. ; Schwartz, Myron ; Harrington, Elizabeth ; Harrington, Martin ; Roman, Sheila H. ; Stagnaro-Green, Alex. / Leukocyte scanning with 111In is superior to magnetic resonance imaging in diagnosis of clinically unsuspected osteomyelitis in diabetic foot ulcers. In: Diabetes Care. 1992 ; Vol. 15, No. 11. pp. 1527-1530.
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AU - Palestro, Christopher J.

AU - Hermann, George

AU - Klein, Michael J.

AU - Schwartz, Myron

AU - Harrington, Elizabeth

AU - Harrington, Martin

AU - Roman, Sheila H.

AU - Stagnaro-Green, Alex

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N2 - OBJECTIVE - To compare the accuracies of MRI and leukocyte scanning in diagnosing clinically unsuspected osteomyelitis in diabetic foot ulcers. RESEARCH DESIGN AND METHODS - A prospective study of 16 diabetic foot ulcers in 12 patients, including both ambulatory and hospitalized patients, was performed at a university medical center. Pedal images were obtained by leukocyte scanning with [111In]oxyquinoline and MRI. Definitive diagnosis of osteomyelitis then was determined by bone biopsy for culture and histology. RESULTS - Biopsy-proven osteomyelitis was present in 7 (44%) of the 16 foot ulcers. The diagnosis was suspected clinically in 0%. Leukocyte scanning was 100% sensitive, whereas MRI was only 29% sensitive in diagnosing osteomyelitis in diabetic foot ulcers. Specificities were 67 and 78%, respectively. The positive and negative predictive values (70 and 100%, respectively) for the leukocyte scan also were greater than those of MRI (50 and 58%, respectively). CONCLUSIONS - Leukocyte scanning is superior to MRI in detecting clinically unsuspected osteomyelitis in diabetic foot ulcers.

AB - OBJECTIVE - To compare the accuracies of MRI and leukocyte scanning in diagnosing clinically unsuspected osteomyelitis in diabetic foot ulcers. RESEARCH DESIGN AND METHODS - A prospective study of 16 diabetic foot ulcers in 12 patients, including both ambulatory and hospitalized patients, was performed at a university medical center. Pedal images were obtained by leukocyte scanning with [111In]oxyquinoline and MRI. Definitive diagnosis of osteomyelitis then was determined by bone biopsy for culture and histology. RESULTS - Biopsy-proven osteomyelitis was present in 7 (44%) of the 16 foot ulcers. The diagnosis was suspected clinically in 0%. Leukocyte scanning was 100% sensitive, whereas MRI was only 29% sensitive in diagnosing osteomyelitis in diabetic foot ulcers. Specificities were 67 and 78%, respectively. The positive and negative predictive values (70 and 100%, respectively) for the leukocyte scan also were greater than those of MRI (50 and 58%, respectively). CONCLUSIONS - Leukocyte scanning is superior to MRI in detecting clinically unsuspected osteomyelitis in diabetic foot ulcers.

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