[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-449328-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-449328-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","the-value-of-apparent-diffusion-coefficient-from-diffusion-weighted-imaging-in-differentiating-osteomyelitis-and-reactive-bone-marrow-edema-in-diabetic-patients","The Value of Apparent Diffusion Coefficient from Diffusion-Weighted Imaging in Differentiating Osteomyelitis and Reactive Bone Marrow Edema in Diabetic Patients","","This cross-sectional research evaluates whether apparent diffusion coefficient (ADC) from diffusion-weighted imaging can distinguish osteomyelitis from reactive bone marrow edema in diabetic patients with diabetic foot ulcers. Forty-five consecutive patients were grouped into osteomyelitis, reactive bone marrow edema, and healthy bone; osteomyelitis was confirmed by tissue biopsy while RBME was assigned by exclusion. ADC measurements were performed independently by two blinded radiologists, and diagnostic performance was assessed to quantify accuracy, sensitivity, specificity, and AUC.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/the-value-of-apparent-diffusion-coefficient-from-diffusion-weighted-imaging-in-differentiating-osteomyelitis-and-reactive-bone-marrow-edema-in-diabetic-patients/449328/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/the-value-of-apparent-diffusion-coefficient-from-diffusion-weighted-imaging-in-differentiating-osteomyelitis-and-reactive-bone-marrow-edema-in-diabetic-patients/449328.png","ImageObject",300,407,{"name":42,"@type":43},"Bulrr","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-01","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",14,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the main diagnostic goal of this study?","Question",{"text":63,"@type":64},"To evaluate the diagnostic performance of the apparent diffusion coefficient (ADC) from diffusion-weighted imaging in distinguishing osteomyelitis from reactive bone marrow edema in diabetic patients with diabetic foot ulcers.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How were patients grouped and how was osteomyelitis confirmed?",{"text":68,"@type":64},"The study included three groups of consecutive diabetic foot ulcer patients: those with osteomyelitis, those with reactive bone marrow edema, and those with healthy bone. Osteomyelitis was confirmed by tissue biopsy, while RBME was diagnosed by exclusion.",{"name":70,"@type":61,"acceptedAnswer":71},"Which ADC threshold and performance metrics were reported?",{"text":72,"@type":64},"Using a cut-off value of 1478.0 × 10⁻⁶ mm²/s, ADC differentiated osteomyelitis from RBME with 88.2% accuracy, 94.4% sensitivity, 81.2% specificity, and an AUC of 0.958.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},449328,1790776561,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":107,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},5909892115043,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","RESEARCH ARTICLE  \nThe Value of Apparent Diffusion Coefficient from DiffusionWeighted Imaging in Differentiating Osteomyelitis and Reactive Bone Marrow Edema in Diabetic Patients  \nSeyedeh Hanie Afzalabadi, MD; Farrokh Seilanian Toosi, MD; Ghasem Zamani, MD; Alireza Mousavian, MD; Amir Mahmoud Ahmadzadeh, MD; Behzad Aminzadeh, MD  \nResearch performed at Mashhad University of Medical Sciences (MUMS), Mashhad, Iran Received: 13 August 2024 Accepted: 13 April 2025  \nAbstract  \nObjectives: This study evaluated the diagnostic performance of the apparent diffusion coefficient (ADC) in distinguishing osteomyelitis from reactive bone marrow edema (RBME) .  \nMethods: This cross-sectional study included three groups of consecutive patients with diabetic foot ulcers (DFU) presenting with osteomyelitis, RBME, or healthy bone. All patients had DFU and were referred for magnetic resonance imaging (MRI) . Patients with a history of foot surgery or biopsy before MRI, those who received antibiotic therapy for three or more days before imaging, and those with contraindications to MRI were excluded from the study. Osteomyelitis was confirmed by tissue biopsy, whereas RBME was diagnosed by exclusion. All participants underwent diffusion-weighted imaging (DWI), and ADC values were measured independently by two radiologists who were blinded to the clinical diagnosis. The diagnostic performance of ADC was then assessed.  \nResults: A total of 45 patients with diabetic foot ulcers (DFU) were recruited, of whom 18 (40 .0%) had osteomyelitis, 16 (35 .6%) had reactive bone marrow edema (RBME), and 11 (24 .4%) had healthy bone tissue. Osteomyelitis demonstrated significantly higher ADC values compared to normal bone (P \u003C 0.001) and significantly lower ADC values compared to RBME (P \u003C 0.001) . Using a cut-off value of 1478.0 × 10⁻⁶ mm²/s, ADC differentiated osteomyelitis from RBME with an accuracy of 88 .2%, sensitivity of 94.4%, specificity of 81.2%, and an area under the curve (AUC) of 0.958.  \nConclusion: These findings support the applicability of diffusion-weighted imaging (DWI) as a non-invasive and accurate diagnostic tool for differentiating osteomyelitis from reactive bone marrow edema.  \nLevel of evidence: IV  \nKeywords: Diabetes mellitus , Magnetic resonance imaging , Osteomyelitis , Reactive bone marrow edema  \nIntroduction  \nD iabetic foot ulcers (DFUs) are among the major  \ncomplications affecting patients with diabetes  \nmellitus. The extent of tissue involvement in DFUs ranges from superficial ulcers to bone abnormalities, including reactive bone marrow edema (RBME), osteomyelitis, and intraosseous abscesses. Differentiating osteomyelitis from diabetic osteoarthropathy-related RBME is clinically significant and represents one of the most challenging diagnoses in patients with DFUs.1 Delayed diagnosis of osteomyelitis increases the risk of permanent tissue damage and subsequent amputation.2  \nVarious imaging modalities have been employed to diagnose diabetic foot osteomyelitis, including plain radiography, conventional magnetic resonance imaging (MRI), nuclear scintigraphy, fluorodeoxyglucose positron emission tomography (FDG PET), and labeled white blood cell PET. However, the utility of these modalities may be limited, as reactive bone marrow edema (RBME) can mimic osteomyelitis across different imaging techniques.3,4 Recent reports also underscore diagnostic pitfalls in osteomyelitis presentations on musculoskeletal imaging Likewise,5 highlights the ongoing burden of MSK infection (e.g., septic  \narthritis), reinforcing the need for precise imaging-based diagnosis. 6 Early signs ofosteomyelitis typically appear on plain radiographs only after approximately two weeks, rendering this modality insensitive during the early stages of the disease.7  \nAlthough nuclear scintigraphy is sensitive, its specificity remains relatively low.8 Currently, conventional MRI is considered the imaging modality of choice for diagnosing pedal osteomyelitis. How","cbCaijp5BjtoItGt","https://ap.wps.com/l/cbCaijp5BjtoItGt","pdf",1123047,"English","# Abstract\n## Objectives\n## Methods\n## Results\n## Conclusion\n# Introduction\n# Materials and Methods","[{\"question\":\"What is the main diagnostic goal of this study?\",\"answer\":\"To evaluate the diagnostic performance of the apparent diffusion coefficient (ADC) from diffusion-weighted imaging in distinguishing osteomyelitis from reactive bone marrow edema in diabetic patients with diabetic foot ulcers.\"},{\"question\":\"How were patients grouped and how was osteomyelitis confirmed?\",\"answer\":\"The study included three groups of consecutive diabetic foot ulcer patients: those with osteomyelitis, those with reactive bone marrow edema, and those with healthy bone. Osteomyelitis was confirmed by tissue biopsy, while RBME was diagnosed by exclusion.\"},{\"question\":\"Which ADC threshold and performance metrics were reported?\",\"answer\":\"Using a cut-off value of 1478.0 × 10⁻⁶ mm²/s, ADC differentiated osteomyelitis from RBME with 88.2% accuracy, 94.4% sensitivity, 81.2% specificity, and an AUC of 0.958.\"}]","The Value of Apparent Diffusion Coefficient from Diffusion-Weighted Imaging in Differentiating Osteomyelitis and Reactive Bone Marrow Edema in Diabetic Patients | PDF",1790729887,18]