Diabetic Neuropathy and Diabetic Foot

Patients with diabetes may present with an array of foot disorders that include, but are not limited to, neuropathy, ulceration, and osteomyelitis. Ischemia and infection are common clinical concerns as either, or both, may be involved in the pathogenesis of these disorders. Management choices can be difficult to make and diagnostic imaging is often sought to help clarify the clinical picture. The imaging options available all have strengths and weaknesses in terms of their clinical relevance. A common problem encountered with imaging is distinguishing inflammation that is due to trauma—e.g. surgical, mechanical or Charcot arthropathy—from soft-tissue or osseous infection. This article reviews the most common imaging options available to clinicians and summarizes the benefits and drawbacks of each. No single imaging modality can answer all the clinical questions that arise in the setting of the diabetic foot, but knowing the features of the imaging choices available to you may help answer the most pressing questions.