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Semin Musculoskelet Radiol 2023; 27(01): 073-090
DOI: 10.1055/s-0043-1761494
Review Article

Bone Marrow Changes and Lesions of Diabetic Foot and Ankle Disease: Conventional and Advanced Magnetic Resonance Imaging

Gitanjali Bajaj
1   Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
,
Avneesh Chhabra
2   Department Radiology and Orthopedic Surgery, UT Southwestern, Dallas, Texas
3   Johns Hopkins University and Walton Centre for Neuroscience, Liverpool, United Kingdom
4   University of Dallas, Irving, Texas
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Abstract

Diabetic foot and ankle complications contribute to substantial mortality and morbidity. Early detection and treatment can lead to better patient outcomes. The primary diagnostic challenge for radiologists is distinguishing Charcot's neuroarthropathy from osteomyelitis. Magnetic resonance imaging (MRI) is the preferred imaging modality for assessing diabetic bone marrow alterations and for identifying diabetic foot complications. Several recent technical advances in MRI, such as the Dixon technique, diffusion-weighted imaging, and dynamic contrast-enhanced imaging, have led to improved image quality and increased capability to add more functional and quantitative information.

We discuss the bone marrow abnormalities encountered in daily radiologic assessment: osteopenia, reactive bone marrow edema-like signal, insufficiency fractures, Charcot's neuroarthropathy, osteomyelitis, serous marrow atrophy, digital ischemia, and bone infarcts, along with their pathophysiology and the conventional and advanced imaging techniques used for a comprehensive marrow evaluation.

Keywords

diabetes mellitus - bone marrow - foot and ankle - magnetic resonance imaging - Charcot's neuroarthropathy


Publication History

Article published online:
03 March 2023

© 2023. Thieme. All rights reserved.

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