Diabetic foot osteomyelitis — SCE Endocrinology MCQ

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HardDiabetesDiabetic foot osteomyelitisSCE Endocrinology

A diabetic plantar ulcer has probed to bone for eight weeks. ESR is 82 mm/hour and radiography shows subtle cortical irregularity but does not define extent. Which imaging test best maps suspected osteomyelitis for treatment planning?

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Correct answer: C — MRI of the affected foot with gadolinium contrast

The best answer is “MRI of the affected foot with gadolinium contrast”. MRI provides the best assessment of marrow and soft-tissue involvement when osteomyelitis remains suspected after clinical assessment and plain radiography. “Ankle–brachial pressure index as the principal investigation” is less appropriate because perfusion testing is important but does not map bone infection “Dual-energy X-ray absorptiometry of the affected lower limb” is less appropriate because DXA measures bone density and cannot define focal infection “CT pulmonary angiography for suspected embolic disease” is less appropriate because pulmonary vascular imaging is anatomically irrelevant “Ultrasound of the contralateral foot” is less appropriate because contralateral ultrasound does not evaluate the affected bone or deep tissues

Reference: NICE NG19: Diabetic foot problems — prevention and management. https://www.nice.org.uk/guidance/ng19/chapter/Recommendations