الفهرس 
Introduction & Review of LiteratureOnly 14 pages are availabe for public view
 |  | from | 116 |  |  |
| | | from | 116 | | |
Abstract
Hyperglycemia, microvascular dysfunction, and peripheral sensory neuropathy make the skin more vulnerable to damage in people with diabetes. In addition, it slows healing and increases the risk of infection in the affected area. charcot’s joint (progressive arthropathy caused by neuropathy), ulceration, infection, gangrene, and amputation are all possible problems in the lower limb. Even in the presence of a soft tissue lesion, the clinical evaluation of the swollen, red, and hot foot for the presence of osteomyelitis is poor.
Because of its accessibility, low cost, and high bone resolution, radiography is the favoured first imaging modality. Only around 50–60 per cent of osteomyelitis cases can be detected because the soft tissues have not been effectively proven. Soft tissue infection and osteomyelitis of the foot may be diagnosed with MR imaging with a 90% sensitivity and 83% specificity, respectively. Additionally, preoperative mapping of the infection site is possible, which may help to restrict the amount of tissue removed after surgery. Diabetic pedal osteomyelitis can only be accurately detected with MR imaging in conjunction with radiography (and its differentiation from neuroarthropathy)
Diagnostic bone edoema and infectious consequences may be better identified by morphologic MR imaging because of the Dixon sequence’s higher sensitivity and accuracy (89.6 percent) and the absence of contrast medium in diabetic patients, particularly those with renal impairment.
To better understand the complicated pathophysiology of bone marrow or soft-tissue edoema in the diabetic foot, functional information from DWI and DCE MR Imaging may be useful. Detection of bone disease is 94.6 percent sensitive, whereas soft tissue disease is 100% sensitive, but only 99.9 percent accurate, when DWI is used at high b values (as in the example above). The sensitivity and accuracy of DCE MR in the diagnosis of osteomyelitis in diabetic foot patients was 100% and 97.3 percent, but its usage should be cautious since it was employed among diabetes patients who may have renal impairment.
Recommendations
For patients with diabetes, Dixon sequence should be included to all musculoskeletal tests in order to avoid contrast-induced nephropathy and to decrease the time and expense of the examination..