THE DIABETIC FOOT

Foot disease in patients with diabetes mellitus is multifactorial and results from a combination of peripheral neuropathy, vascular compromi se and superimposed infection. Foot complications in diabetic patients are common and account for more hospital days than any other aspects of their disease. Therefore, familiarity with the spectrum of findings in the different imaging modalities appears essential. Radiographical ly, significant changes include Charcot joints of the tarsus (destruct ive type) and bone absorption of the forefoot (mutilating type). In di abetic foot problems, magnetic resonance imaging and leukocyte scintig raphy appear to be the most effective tools for detection of osteomyel itis, and a negative study makes osteomyelitis unlikely. However, the findings of both techniques in active, noninfected neuropathic osteoar thropathy may be indistinguishable from those of osteomyelitis.