Diagnostic Imaging of Diabetic Foot Disorders

Plain, weight-bearing radiography is the preferred first-line imaging. Dependent on the suspected pathology, further imaging is indicated. In a soft tissue infection, an abscess has to be excluded, for example, with ultrasound. Osteomyelitis has a typical triad including osteolysis, periosteal reaction, and bone destruction in radiography, but signs are often delayed. MRI is the gold standard for diagnosis of osteomyelitis with high intensity in T2-weighted and STIR images and intermediate to decreased reticulated hazy intensity in T1-weighted images. In comparison, bone marrow edema is also bright on the T2-weighted image but the T1-weighted image has a confluent low intensity.