Kaleta JL, Fleischli JW, Reilly CH, et al.
Journal of the American Podiatric Medical Association. Date of publication 2001 Oct 1;volume 91(9):445-50.
1. J Am Podiatr Med Assoc. 2001 Oct;91(9):445-50.
The diagnosis of osteomyelitis in diabetes using erythrocyte sedimentation rate:
a pilot study.
Kaleta JL(1), Fleischli JW, Reilly CH.
Author information:
(1)Illinois Masonic Medical Center, 3000 N Halsted, Ste 500, Chicago, IL 60657,
USA.
Comment in
J Am Podiatr Med Assoc. 2002 May;92(5):314; author reply 314-5.
Osteomyelitis secondary to diabetic foot infections can lead to proximal
amputation if not diagnosed in a timely and accurate manner. The authors have
found no studies to date that correlate a specific erythrocyte sedimentation rate
with osteomyelitis. A retrospective chart review of 29 diabetic patients admitted
to the hospital with diagnoses of osteomyelitis or cellulitis of the foot during
a 1-year period was performed. Of the various lab values and demographic factors
compared, erythrocyte sedimentation rate was the only measure that differed
significantly between the two groups. A receiver operating characteristic curve
was used to obtain the optimal cutoff value of 70 mm/h, a level above which
osteomyelitis was present with the highest sensitivity (89.5%) and highest
specificity (100%), along with a positive predictive value of 100% and a negative
predictive value of 83%. This study shows that in combination with clinical
suspicion in diabetic foot infections, the erythrocyte sedimentation rate is
highly predictive of osteomyelitis, and that the value of 70 mm/h is the optimal
cutoff to predict accurately the presence or absence of bone infection.
PMID: 11679625 [Indexed for MEDLINE]
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