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Foot infections in diabetic patients can suggest underlying osteomyelitis. Two studies support decision-making based on clinical evaluation rather than testing with nuclear and magnetic resonance imaging techniques.
Eckman et al. performed a decision and cost-effectiveness analysis comparing several approaches to the diagnosis and treatment of diabetics with foot infections. Options included antibiotic treatment for a presumed soft-tissue infection, culture-guided antibiotic treatment for presumed osteomyelitis, amputation, and various combinations of tests before antibiotic therapy or amputation.
The analysis, based on published data, found that noninvasive testing was the most expensive strategy except for immediate amputation, and did not …