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Diabetic foot osteomyelitis — SCE Endocrinology MCQ

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ModerateDiabetesDiabetic foot osteomyelitisSCE Endocrinology

A 64-year-old woman with type 2 diabetes has a painless plantar ulcer under the first metatarsal head. Probe-to-bone test is positive and foot X-ray shows cortical erosion. She is afebrile and pulses are present. What is the most likely diagnosis?

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Correct answer: A — Diabetic foot osteomyelitis

A chronic neuropathic ulcer with a positive probe-to-bone test and bony erosion is highly suggestive of osteomyelitis. Charcot can cause a hot swollen foot but does not usually present as a probe-to-bone ulcer diagnosis. Specialist multidisciplinary foot care is essential to reduce amputation risk.

Reference: NICE NG19; IWGDF Guidance