Diagnosing diabetic foot osteomyelitis: narrative review and a suggested 2-step score-based diagnostic pathway for clinicians

Open Forum Infectious Diseases
Anurag Markanday

Abstract

The diabetic foot infection remains a major cause of morbidity and mortality in many patients and remains a challenging diagnosis for most clinicians. Diagnosis is largely based on clinical signs supplemented by various imaging tests. Magnetic resonance imaging (MRI) is not readily available to many clinicians, and bone biopsy, which is the accepted criterion standard for diagnosis, is rarely performed routinely. This evidence-based review and the proposed diagnostic scoring pathway substratifies the current International Working Group on the Diabetes Foot guidelines for diagnosing diabetic foot osteomyelitis into a convenient 2-step diagnostic pathway for clinicians. This proposed diagnostic approach will need further validation prospectively, but it can serve as a useful diagnostic tool during the initial assessment and management of diabetic foot infections. A MEDLINE search of English-language articles on diabetic foot osteomyelitis published between 1986 and March 2014 was conducted. Additional articles were also identified through a search of references from the retrieved articles, published guidelines, systematic reviews, and meta-analyses.

References

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Citations

Sep 20, 2015·Diabetes/metabolism Research and Reviews·Benjamin A LipskyEdgar J G Peters
Aug 11, 2015·Open Forum Infectious Diseases·Anurag Markanday
Jan 14, 2020·Journal of Wound Care·Aroa Tardáguila-GarcíaJosé Luis Lázaro-Martínez
Oct 28, 2019·La Radiologia medica·Antonio LeoneCesare Colosimo
Jun 12, 2020·Journal of Clinical Medicine·Chiara LauriLuigi Uccioli
Nov 8, 2017·The International Journal of Lower Extremity Wounds·Maria DemetriouEfstratios Maltezos
Jul 28, 2016·Expert Review of Anti-infective Therapy·O RobineauE Senneville
Sep 12, 2017·International Journal of Clinical Practice·Nicholas D BarwellUNKNOWN Scottish Diabetes Foot Action Group
Nov 3, 2020·Open Forum Infectious Diseases·Marcos C SchechterRussell R Kempker
Dec 4, 2020·Journal of Clinical Medicine·Aroa Tardáguila-GarcíaJosé Luis Lázaro-Martínez
Aug 27, 2021·Frontiers in Molecular Biosciences·Jun ChenChun Loong Ho
Apr 26, 2017·Endocrinología, Diabetes Y Nutrición·José Luis Lázaro-MartínezJosé Luis García-Klepzig

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Methods Mentioned

BETA
amputations
biopsy
ESR

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