Diagnostic Accuracy of the Physical Examination and Imaging Tests for Osteomyelitis Underlying Diabetic Foot Ulcers: Meta-Analysis

Accurate diagnosis of osteomyelitis underlying diabetic foot ulcers is essential to optimize outcomes. We undertook a meta-analysis of the accuracy of diagnostic tests for osteomyelitis in diabetic patients with foot ulcers. Pooled sensitivity and specificity, the summary measure of accuracy (Q*), a...

Full description

Saved in:
Bibliographic Details
Published in:Clinical infectious diseases 2008-08, Vol.47 (4), p.519-527
Main Authors: Dinh, Marie T., Abad, Cybele L., Safdar, Nasia
Format: Article
Language:English
Subjects:
Accuracy
Bone diseases
Bones
Diabetes
Diabetes complications
Diabetic foot
Diabetic Foot - complications
Diagnostic Imaging - instrumentation
Diagnostic Imaging - methods
Diagnostic tests
Foot ulcer
Humans
Imaging
Indium Radioisotopes
Leukocytes
Magnetic Resonance Imaging
Medical diagnosis
Medical diagnostic tests
Meta-analysis
Monitoring, Physiologic
Osteomyelitis
Osteomyelitis - complications
Osteomyelitis - diagnosis
Osteomyelitis - diagnostic imaging
Oxyquinoline
Physical Examination
Physical examinations
Radiography
Radionuclide Imaging - methods
Reproducibility of Results
Review Articles
Sensitivity and Specificity
Ulcers
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Accurate diagnosis of osteomyelitis underlying diabetic foot ulcers is essential to optimize outcomes. We undertook a meta-analysis of the accuracy of diagnostic tests for osteomyelitis in diabetic patients with foot ulcers. Pooled sensitivity and specificity, the summary measure of accuracy (Q*), and diagnostic odds ratio were calculated. Exposed bone or probe-to-bone test had a sensitivity of 0.60 and a specificity of 0.91. Plain radiography had a sensitivity of 0.54 and a specificity of 0.68. MRI had a sensitivity of 0.90 and a specificity of 0.79. Bone scan was found to have a sensitivity of 0.81 and a specificity of 0.28. Leukocyte scan was found to have a sensitivity of 0.74 and a specificity of 0.68. The diagnostic odds ratios for clinical examination, radiography, MRI, bone scan, and leukocyte scan were 49.45, 2.84, 24.36, 2.10, and 10.07, respectively. The presence of exposed bone or a positive probe-to-bone test result is moderately predictive of osteomyelitis. MRI is the most accurate imaging test for diagnosis of osteomyelitis.
ISSN:1058-4838
1537-6591
DOI:10.1086/590011