Novel advanced imaging method to differentiate acute osteomyelitis from acute charcot neuroarthropathy in the presence of chronic ulcer: A case series

Foot & ankle surgery (New York, N.Y.) Pub Date : 2025-07-14 DOI:10.1016/j.fastrc.2025.100541

William Pacheco DPM , Carly Cook DPM , Woo Y. Chun DPM , April Wong DPM , Grace Hewett MD , Marianne Bonanno MD , Don Yoo MD , Douglas Glod DPM

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Abstract

Charcot neuroarthropathy presents a diagnostic challenge and is complicated by chronic ulceration, as radiographic and histological findings are similar to osteomyelitis. Traditional techniques for diagnosis, such as bone biopsy and magnetic resonance imaging, lack specificity when attempting to differentiate between these two entities. In our prior case report, it was found that utilizing a comprehensive nuclear medicine imaging protocol starting with a bone scan utilizing Technetium-99 m methyl diphosphonate with single photon emission computed tomography-computed tomography (SPECT/CT) followed by an additional nuclear medicine study utilizing indium-111 labeled white blood cells and Technetium-99 m sulfur colloid with single photon emission computed tomography-computed tomography allowed differentiation between these two entities. This case series utilized this protocol and found that it allows for differentiation between these two entities even after Charcot reconstructions with chronic ulcerations. This protocol allows for improved diagnostic specificity and surgical planning for complex limb salvage.

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一种新的先进的影像学方法来区分急性骨髓炎和慢性溃疡的急性神经关节病：一个病例系列

Charcot神经关节病的诊断具有挑战性，并伴有慢性溃疡，因为影像学和组织学结果与骨髓炎相似。传统的诊断技术，如骨活检和磁共振成像，在试图区分这两种实体时缺乏特异性。在我们之前的病例报告中，研究发现，利用全面的核医学成像方案，首先使用单光子发射计算机断层扫描（SPECT/CT）进行骨扫描，然后使用铟-111标记的白细胞和单光子发射计算机断层扫描（CT）进行额外的核医学研究，可以区分这两个实体。本病例系列采用该方案，发现即使在沙科重建慢性溃疡后，也可以区分这两种实体。该方案允许改进诊断特异性和复杂肢体保留的手术计划。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Foot & ankle surgery (New York, N.Y.) Orthopedics, Sports Medicine and Rehabilitation, Podiatry

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0.00%

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审稿时长

75 days