TABLE 1

Results of Labeled Leukocyte Scintigraphy (Planar plus SPECT) and SPECT/CT: Data on 15 Patients with Suspected Diabetic Foot Infection and Positive Scan Findings

Patient no.Location of ulcerClinical featuresSuspected infectionPlanar plus SPECT findingsSPECT/CT findingsSPECT/CT clinical contributionFinal diagnosis
1First toe, LUlcer, foot pain, feverOMInfection in toe (OM)STIExclusion of OMSTI* (FU)
2Mid foot, RFoot pain, edema, ulcerOM and STIInfection in metatarsus and neighboring soft tissue (OM and STI)STIExclusion of OMSTI* (B/C = S. aureus, FU)
3Calcaneus, R; forefoot, RUlcers, pain, edemaOMInfection in calcaneus and metatarsus (OM)STI in both sitesExclusion of OMSTI* (B/C = S. aureus, FU); STI* (B/C = S. aureus, FU)
4Calcaneus, RNonhealing wound, pain, feverOMInfection in calcaneus (OM)OM and STI in calcaneusDefining extent of diseaseOM and STI (B/C = PA, FU)
5Metatarsus, RNonhealing wound, pain, edemaOMInfection in metatarsus (OM)OM in first metatarsusNot significantOM (B/C = PA, FU)
6First toe, RUlcer, fever, painSTIInfection in soft tissue (STI)OM and STIDefining extent of diseaseOM and STI (B/C = PA, FU)
7Metatarsus, LFoot pain, edema, cellulitis, ulcerSTIInfection in soft tissue (STI)STINot significantSTI* (FU)
8Calcaneus, R; metatarsus, RUlcers, pain, edema, feverOMInfection in calcaneus (OM) and metatarsus (OM)STI in calcaneus and OM in metatarsusNot significant (OM in metatarsus), excluding OM in calcaneusOM (B/C = PA, FU); STI* (B/C = PA, FU)
9Metatarsus, LFoot pain, ulcer, edemaOMInfection in metatarsus, location uncertain (OM vs. STI)STI in metatarsusExclusion of OMSTI* (B/C = S. pyogenes, FU)
10Hind foot, LNonhealing wound, foot pain, edemaSTIInfection in soft tissue of the external aspect of hindfoot (STI)OM of the external malleolusDiagnosis is OMOM (B/C = PA, FU)
11Fourth toe, LFever, edema, nonhealing woundOMInfection in toe (OM)OMNo significant contributionOM (FU)
12Metatarsus, LUlcer, fever, cellulitisOMInfection in metatarsal soft tissue (STI)OM and STIDefining extent of diseaseOM and STI (B/C = PA, FU)
13Calcaneus, RUlcer, foot pain, edemaOMInfection in calcaneus (OM)STIExclusion of OMSTI* (B/C = S. aureus, FU)
14Second toe, RUlcer, edema, feverOMInfection in toe (OM)OMNot significantOM (FU)
15First toe, LEdema, nonhealing woundSTINo infectionNo infectionNot significantCharcot foot (FU: typical bone alterations at MRI)§
16Hind foot, RNonhealing woundSTINo infectionNo infectionNot significantIschemic ulcer (B/C = no infection, FU)§
17Fifth toeNonhealing wound, painOMNo infectionNo infectionNot significantIschemic ulcer (B/C = no infection, FU)§
  • * All cases treated for STI with adequate clinical response during FU.

  • Same patient, 2 sites of infection.

  • Clinical observation and serial radiologic studies showing bone alterations typical of osteomyelitis.

  • § All patients were free from infection at FU.

  • OM = osteomyelitis; STI = soft-tissue infection; FU = follow-up; B/C = biopsy and bacteriologic cultures; PA = polymicrobial agents.