Abscess
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Advanced Imaging of the Diabetic Foot and Its Complications
Copyright 1999 T. Learch, A. Gentili. All rights reserved.
Revised: November 16, 2004.

The diagnosis of abscess formation is one of the most important aspects of imaging. Diabetics do not tolerate undrained pus.[Gibbons et al] Drainage of an abscess is vitally important in saving diabetic feet.[Bose K.]

MR imaging is the best imaging modality for the evaluation of abscesses. Focal fluid collections are readily seen on T2 and STIR images. Intravenous contrast is rarely necessary for confident diagnosis, but in some cases may be helpful. Due to limited soft tissue resolution, nuclear medicine is poor in diagnosing abscesses, and this is a major limitation in the use of this modality in the evaluation of the diabetic foot.

A B
C D

55-year-old man with diabetes. (A) Nuclear medicine bone scan demonstrates abnormal tracer activity in the forefoot consistent with osteomyelitis. (B-C) Long and short axis STIR images of the forefoot demonstrate multiple areas of abnormal bone marrow signal consistent with multifocal osteomyelitis as well as abscess in the plantar soft tissues. (D) Short axis T1 weighted image with fat saturation post intravenous gadolinium administration demonstrates typical enhancement of the soft tissues peripheral to the abscess. (Click on the images to see larger versions)

 

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Advanced Imaging of the Diabetic Foot and Its Complications
Copyright 1999 T. Learch, A. Gentili. All rights reserved.
Revised: April 29, 2006.
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