Diabetic foot osteomyelitis — SCE Endocrinology MCQ

Instant feedback + full explanation. One question, done properly.

HardDiabetes complicationsDiabetic foot osteomyelitisSCE Endocrinology

A 61-year-old man with neuropathic diabetes has a plantar ulcer over the fifth metatarsal head. It probes to bone and has persisted for 8 weeks despite offloading. ESR is 86 mm/hour and plain X-ray shows cortical erosion. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Diabetic foot osteomyelitis

Diabetic foot osteomyelitis is best because a chronic ulcer probing to bone with raised inflammatory markers and cortical erosion is highly suggestive of osteomyelitis. The alternatives are less appropriate because Charcot causes bony fragmentation without an ulcer probing to bone; venous eczema and plantar fasciitis do not erode cortex; gout may mimic infection but the ulcer pattern is decisive. The SCE teaching point is to integrate the clinical pattern, biochemistry and context rather than treating an isolated result.

Reference: NICE NG19 diabetic foot problems