Radiological imaging
As previously discussed radiological imaging in diagnosis of osteomyelitis has a fundamental part to play, but plain x-rays can also be used to visualise fluid collections, gas within the soft tissues, foreign bodies and Charcot neuroarthropathy.
It can be difficult to clinically differentiate between soft tissue reactions such as Charcot neuroarthropathy and cellulitis (see image below), even after elevation of the limb to check whether Charcot signs are diminished. Radiological imaging and rapid referral to one of the Multidisciplinary Foot teams within 24 hours is essential for diagnosis and management.
Image: A hot red foot in acute Charcot neuro-osteoarthropathy
Reproduced from: ‘The Radiology Assistant’, Diabetic foot, by Ivo Schoots, Mario Mass and Robin Smithuis.
