Pub Date : 2025-07-28DOI: 10.1016/j.fastrc.2025.100553
Lauren Simon DPM , Christopher Doty II BS , Mariana Ocegueda BS , Mitchell L. Goldflies MD., FAAOS
Phlegmasia cerulea dolens (PCD) is a rare and severe manifestation of deep vein thrombosis (DVT) characterized by extensive venous obstruction extending into collateral veins.1 PCD’s relationship to compartment syndrome and gangrene is known but has not yet been thoroughly studied.2 We present a case of PCD in a pre-menopausal woman, who developed compartment syndrome, post fasciotomy wound infection, and required subsequent multi-digit amputations due to dry gangrene. The patient presented initially to another hospital where they performed a right superficial femoral artery to anterior tibial bypass with reversed saphenous vein with right leg four compartment decompression fasciotomies. This case covers the severity of PCD and its ability to cause irreversible tissue damage even with timely intervention.
{"title":"Gangrene of digits from phlegmasia cerulea dolens: A case report","authors":"Lauren Simon DPM , Christopher Doty II BS , Mariana Ocegueda BS , Mitchell L. Goldflies MD., FAAOS","doi":"10.1016/j.fastrc.2025.100553","DOIUrl":"10.1016/j.fastrc.2025.100553","url":null,"abstract":"<div><div>Phlegmasia cerulea dolens (PCD) is a rare and severe manifestation of deep vein thrombosis (DVT) characterized by extensive venous obstruction extending into collateral veins.<sup>1</sup> PCD’s relationship to compartment syndrome and gangrene is known but has not yet been thoroughly studied.<sup>2</sup> We present a case of PCD in a pre-menopausal woman, who developed compartment syndrome, post fasciotomy wound infection, and required subsequent multi-digit amputations due to dry gangrene. The patient presented initially to another hospital where they performed a right superficial femoral artery to anterior tibial bypass with reversed saphenous vein with right leg four compartment decompression fasciotomies. This case covers the severity of PCD and its ability to cause irreversible tissue damage even with timely intervention.</div><div>Level of Evidence: 4</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100553"},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-26DOI: 10.1016/j.fastrc.2025.100550
Victoria M. Nolte DPM, MS, Ashley L. Bowles DPM, FACFAS, Kyle J. Kinmon DPM, MS, FACFAS
There have been volumes of literature published evaluating “Double Crush Syndrome” (DCS) and nerve pain treatment options, with little data centered on neuropathy specifically of the lower extremity. “Double Crush Syndrome” references a compression at two or more locations across a peripheral nerve that can synergize symptoms. Many surgeons will not attempt procedural treatment of this patient population due to the belief of a high risk-reward ratio. The objective of this case series is to evaluate patients suffering from lower extremity peripheral nerve entrapment and the impact of lower extremity nerve decompressions in the setting of radiculopathy. Twenty-seven patients treated with lower extremity nerve decompressions were followed for a minimum of 3 years. Outcomes were measured by subjective overall improvement in neuropathic pain. Twenty-five patients experienced pain relief post-operatively, including two patients who underwent a subsequent soleal sling tibial nerve decompression which improved their outcome. Two patients experienced no pain relief, though did not report an increase in their pain.
{"title":"Outcomes of lower extremity peripheral nerve decompressions in the setting of radiculopathy","authors":"Victoria M. Nolte DPM, MS, Ashley L. Bowles DPM, FACFAS, Kyle J. Kinmon DPM, MS, FACFAS","doi":"10.1016/j.fastrc.2025.100550","DOIUrl":"10.1016/j.fastrc.2025.100550","url":null,"abstract":"<div><div>There have been volumes of literature published evaluating “Double Crush Syndrome” (DCS) and nerve pain treatment options, with little data centered on neuropathy specifically of the lower extremity. “Double Crush Syndrome” references a compression at two or more locations across a peripheral nerve that can synergize symptoms. Many surgeons will not attempt procedural treatment of this patient population due to the belief of a high risk-reward ratio. The objective of this case series is to evaluate patients suffering from lower extremity peripheral nerve entrapment and the impact of lower extremity nerve decompressions in the setting of radiculopathy. Twenty-seven patients treated with lower extremity nerve decompressions were followed for a minimum of 3 years. Outcomes were measured by subjective overall improvement in neuropathic pain. Twenty-five patients experienced pain relief post-operatively, including two patients who underwent a subsequent soleal sling tibial nerve decompression which improved their outcome. Two patients experienced no pain relief, though did not report an increase in their pain.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100550"},"PeriodicalIF":0.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-23DOI: 10.1016/j.fastrc.2025.100545
Akshay Jain , Garrett B. Nguyen , Andrew K. Lamm , Bradley M. Lamm
Few reports have been published regarding septic ankle or charcot neuroarthropathy deformities with a fibular strut allograft construct. A retrospective review was conducted to examine the radiographic and clinical outcomes of using fibular allograft struts as intramedullary fixation to assist in hindfoot and ankle arthrodesis for limb salvage in patients with prior infections. 6 patients were identified, 5 patients met the inclusion and exclusion criteria. Three (60 %) patients had an initial diagnosis of Charcot neuroarthropathy with two (20 %) patients having an initial diagnosis of septic arthritis. All the patients (100 %) had various stages of wounds prior to surgery. Four patients had multiplanar external fixator devices applied prior to hindfoot arthrodesis with fibular strut allograft (Index procedure). One patient had an external fixator applied at the same time as the index procedure. External fixator devices were applied on average of 4.5 months (range, 3.97–5.33), were applied an average of 27 days before surgery (range, 4–60), and removed 3.9 months after surgery (range, 3.3–4.7). After external fixators were removed patients were placed into a fiberglass short leg cast for an average of 2.5 months (range, 1.4–4.2). At a 6 month postoperative CT scan, 80 % of patients achieved osseous union. This complex patient population has been shown to have poor union rates. Overall, the microvascular and macrovascular disease secondary to the uncontrolled hyperglycemia in diabetic patients, poor blood flow in patients with peripheral vascular disease, and suboptimal outcomes in cases of infection contributes to increased nonunion rates. This technique demonstrates a novel and viable approach in prior ankle and hindfoot infection cases. A locking, nonmetal construct in combination with fibular strut autograft needs to be considered routinely in this patient population as many of these patients either are faced with nonsurgical options or face amputation.
{"title":"Non-metal locking construct for hindfoot and ankle arthrodesis using intramedullary fibular allograft strut in cases with prior infection","authors":"Akshay Jain , Garrett B. Nguyen , Andrew K. Lamm , Bradley M. Lamm","doi":"10.1016/j.fastrc.2025.100545","DOIUrl":"10.1016/j.fastrc.2025.100545","url":null,"abstract":"<div><div>Few reports have been published regarding septic ankle or charcot neuroarthropathy deformities with a fibular strut allograft construct. A retrospective review was conducted to examine the radiographic and clinical outcomes of using fibular allograft struts as intramedullary fixation to assist in hindfoot and ankle arthrodesis for limb salvage in patients with prior infections. 6 patients were identified, 5 patients met the inclusion and exclusion criteria. Three (60 %) patients had an initial diagnosis of Charcot neuroarthropathy with two (20 %) patients having an initial diagnosis of septic arthritis. All the patients (100 %) had various stages of wounds prior to surgery. Four patients had multiplanar external fixator devices applied prior to hindfoot arthrodesis with fibular strut allograft (Index procedure). One patient had an external fixator applied at the same time as the index procedure. External fixator devices were applied on average of 4.5 months (range, 3.97–5.33), were applied an average of 27 days before surgery (range, 4–60), and removed 3.9 months after surgery (range, 3.3–4.7). After external fixators were removed patients were placed into a fiberglass short leg cast for an average of 2.5 months (range, 1.4–4.2). At a 6 month postoperative CT scan, 80 % of patients achieved osseous union. This complex patient population has been shown to have poor union rates. Overall, the microvascular and macrovascular disease secondary to the uncontrolled hyperglycemia in diabetic patients, poor blood flow in patients with peripheral vascular disease, and suboptimal outcomes in cases of infection contributes to increased nonunion rates. This technique demonstrates a novel and viable approach in prior ankle and hindfoot infection cases. A locking, nonmetal construct in combination with fibular strut autograft needs to be considered routinely in this patient population as many of these patients either are faced with nonsurgical options or face amputation.</div></div><div><h3>Level of evidence</h3><div>3.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100545"},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-23DOI: 10.1016/j.fastrc.2025.100549
Steven R. Cooperman DPM, MBA, AACFAS
{"title":"Corrigendum to “From Theory to Practice: Integrating AI Dictation” [Foot and Ankle Surgery: Techniques, Reports & Cases 5 (2025) 100497]","authors":"Steven R. Cooperman DPM, MBA, AACFAS","doi":"10.1016/j.fastrc.2025.100549","DOIUrl":"10.1016/j.fastrc.2025.100549","url":null,"abstract":"","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100549"},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-22DOI: 10.1016/j.fastrc.2025.100548
Hayden L. Hoffler DPM, AACFAS , Nathaniel A. Ptak DPM , Bryanna D. Vesely DPM, MPH , Joni K. Evans MS , Trevor E. Black DPM, FACFAS
{"title":"Corrigendum to “Incidence and impact of the presence of tarsometatarsal joint arthritis in patients with hallux rigidus: A retrospective radiographic study” [Foot & Ankle Surgery: Techniques, Reports & Cases 4 (2024) 100380]","authors":"Hayden L. Hoffler DPM, AACFAS , Nathaniel A. Ptak DPM , Bryanna D. Vesely DPM, MPH , Joni K. Evans MS , Trevor E. Black DPM, FACFAS","doi":"10.1016/j.fastrc.2025.100548","DOIUrl":"10.1016/j.fastrc.2025.100548","url":null,"abstract":"","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100548"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-22DOI: 10.1016/j.fastrc.2025.100546
Michael L. Sganga , Keith A. Crenshaw
Minimally Invasive Bunion Surgery (MIBS) continues to gain popularity with advancements in fixation systems, although there continues to be a steep learning curve associated with this procedure. This study aims to provide an additional technique to facilitate the placement of accurate and reproducible guidewires for screw fixation. As achieving the desired alignment with the proximal guidewire can be challenging, this study focuses on a reproducible technique that adheres to the important stability principles of MIBS.
This technique describes pre-operative planning for guidewire placement referred to as establishing the “cross-hairs and gunsights”. This provides external visualization to aid in guidewire placement. The 50% rule provides a landmark on lateral x-ray that allows for initial wire placement along the lateral cortex for efficient and accurate positioning that correlates with the expected capital fragment translation.
{"title":"The 50 % rule technique for guidewire placement in minimally invasive bunion surgery","authors":"Michael L. Sganga , Keith A. Crenshaw","doi":"10.1016/j.fastrc.2025.100546","DOIUrl":"10.1016/j.fastrc.2025.100546","url":null,"abstract":"<div><div>Minimally Invasive Bunion Surgery (MIBS) continues to gain popularity with advancements in fixation systems, although there continues to be a steep learning curve associated with this procedure. This study aims to provide an additional technique to facilitate the placement of accurate and reproducible guidewires for screw fixation. As achieving the desired alignment with the proximal guidewire can be challenging, this study focuses on a reproducible technique that adheres to the important stability principles of MIBS.</div><div>This technique describes pre-operative planning for guidewire placement referred to as establishing the “cross-hairs and gunsights”. This provides external visualization to aid in guidewire placement. The 50% rule provides a landmark on lateral x-ray that allows for initial wire placement along the lateral cortex for efficient and accurate positioning that correlates with the expected capital fragment translation.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100546"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-19DOI: 10.1016/j.fastrc.2025.100544
Shevanka Dias Abeyagunawardene , Joseph Paul , Dror Maor
Background
Talar osteochondral lesions (OCLs), often resulting from ankle trauma, affect the cartilage and subchondral talus bone and frequently require surgical intervention when conservative measures fail. Arthroscopic debridement and microfracture are some of the surgical interventions, leaving many patients with ongoing pain even after extended rehabilitation. The osteochondral autograft transfer system (OATS) offers an alternative by restoring hyaline cartilage using grafts from non-weight-bearing knee regions.
Purpose / Study Design
This retrospective case series evaluated the effectiveness of OATS in improving patient-reported outcomes for patients with postero-medial talar OCL.
Methods
All procedures were performed by a single surgeon across three centres in Western Australia. The donor sites for all autografts were from a non-weight bearing region of the lateral femoral condyle on the ipsilateral side. Pre- and post-operative patient-reported outcome measures were collected.
Results
Thirteen patients underwent OATS for talar OCLs from 2020 to 2024, with mean follow-up of 1.99 years. All had failed prior non-operative management, and over half underwent previous arthroscopic debridement. The average lesion size was 169 mm², requiring 1–3 grafts. AOFAS scores improved significantly from 60.3 to 80.2 (p < 0.0001), with no correlation between score change and age, lesion size, number of plugs, nor previous procedures. Donor site morbidity was low (15.4%), reported only as subjective weakness.
Conclusion
OATS is a safe and effective treatment for talar OCLs unresponsive to conservative or previous arthroscopic surgical management. Low donor site morbidity supports the use of ipsilateral knee harvest. Future studies should incorporate validated PROMs and explore predictive factors for surgical success.
{"title":"Knee-to-Talus osteochondral grafting for talar lesions: Mid-term outcomes of the OATS procedure","authors":"Shevanka Dias Abeyagunawardene , Joseph Paul , Dror Maor","doi":"10.1016/j.fastrc.2025.100544","DOIUrl":"10.1016/j.fastrc.2025.100544","url":null,"abstract":"<div><h3>Background</h3><div>Talar osteochondral lesions (OCLs), often resulting from ankle trauma, affect the cartilage and subchondral talus bone and frequently require surgical intervention when conservative measures fail. Arthroscopic debridement and microfracture are some of the surgical interventions, leaving many patients with ongoing pain even after extended rehabilitation. The osteochondral autograft transfer system (OATS) offers an alternative by restoring hyaline cartilage using grafts from non-weight-bearing knee regions.</div></div><div><h3>Purpose / Study Design</h3><div>This retrospective case series evaluated the effectiveness of OATS in improving patient-reported outcomes for patients with postero-medial talar OCL.</div></div><div><h3>Methods</h3><div>All procedures were performed by a single surgeon across three centres in Western Australia. The donor sites for all autografts were from a non-weight bearing region of the lateral femoral condyle on the ipsilateral side. Pre- and post-operative patient-reported outcome measures were collected.</div></div><div><h3>Results</h3><div>Thirteen patients underwent OATS for talar OCLs from 2020 to 2024, with mean follow-up of 1.99 years. All had failed prior non-operative management, and over half underwent previous arthroscopic debridement. The average lesion size was 169 mm², requiring 1–3 grafts. AOFAS scores improved significantly from 60.3 to 80.2 (p < 0.0001), with no correlation between score change and age, lesion size, number of plugs, nor previous procedures. Donor site morbidity was low (15.4%), reported only as subjective weakness.</div></div><div><h3>Conclusion</h3><div>OATS is a safe and effective treatment for talar OCLs unresponsive to conservative or previous arthroscopic surgical management. Low donor site morbidity supports the use of ipsilateral knee harvest. Future studies should incorporate validated PROMs and explore predictive factors for surgical success.</div></div><div><h3>Level of Clinical Evidence</h3><div>Level 4 – Case Series</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100544"},"PeriodicalIF":0.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-17DOI: 10.1016/j.fastrc.2025.100543
Bassem Al Hariri , Muhammad Faizan , Mennatallah Lotfi , Ahmed Alayadi M Salem , Muhammad sharif , Memon Noor Illahi
Tuberculosis (TB) remains a significant global health challenge, with extrapulmonary TB making up about 10 % of all cases. Musculoskeletal TB is a minor component of these cases, with TB of the ankle and foot being exceptionally uncommon, accounting for just 0.1–0.3 % of extrapulmonary TB instances. We introduce a diagnostically challenging case involving a 30-year-old South Asian male who developed primary TB osteomyelitis of the left ankle, which initially presented as a non-healing ulcer resistant to conventional antibiotic treatment.
Characteristic features of osteomyelitis with associated soft tissue involvement were demonstrated by advanced imaging studies, including MRI. The definitive diagnosis was made through PCR and culture confirmation of Mycobacterium tuberculosis from surgical specimens. A thorough evaluation uncovered the presence of concomitant pulmonary TB, underscoring the significance of systemic assessment in cases of extrapulmonary presentations. The patient was effectively treated using a combination of surgical debridement and standard anti-tubercular therapy, showing a favorable early response.
This case demonstrates several vital clinical lessons: the importance of keeping a high suspicion for TB in persistent musculoskeletal lesions, especially in patients from endemic regions; the worth of state-of-the-art diagnostic methods in atypical presentations; and the significance of examining for concurrent pulmonary involvement even in cases of extrapulmonary disease that appear to be isolated. The report bolsters existing guidelines that advocate for a multidisciplinary strategy in TB management, integrating precise microbiological diagnosis, suitable imaging, and extended antimicrobial treatment to avert long-term consequences. Clinicians working in both endemic and non-endemic areas may find these findings especially relevant, as they may come across such atypical presentations.
{"title":"Atypical presentation of musculoskeletal tuberculosis in the ankle: A case report","authors":"Bassem Al Hariri , Muhammad Faizan , Mennatallah Lotfi , Ahmed Alayadi M Salem , Muhammad sharif , Memon Noor Illahi","doi":"10.1016/j.fastrc.2025.100543","DOIUrl":"10.1016/j.fastrc.2025.100543","url":null,"abstract":"<div><div>Tuberculosis (TB) remains a significant global health challenge, with extrapulmonary TB making up about 10 % of all cases. Musculoskeletal TB is a minor component of these cases, with TB of the ankle and foot being exceptionally uncommon, accounting for just 0.1–0.3 % of extrapulmonary TB instances. We introduce a diagnostically challenging case involving a 30-year-old South Asian male who developed primary TB osteomyelitis of the left ankle, which initially presented as a non-healing ulcer resistant to conventional antibiotic treatment.</div><div>Characteristic features of osteomyelitis with associated soft tissue involvement were demonstrated by advanced imaging studies, including MRI. The definitive diagnosis was made through PCR and culture confirmation of Mycobacterium tuberculosis from surgical specimens. A thorough evaluation uncovered the presence of concomitant pulmonary TB, underscoring the significance of systemic assessment in cases of extrapulmonary presentations. The patient was effectively treated using a combination of surgical debridement and standard anti-tubercular therapy, showing a favorable early response.</div><div>This case demonstrates several vital clinical lessons: the importance of keeping a high suspicion for TB in persistent musculoskeletal lesions, especially in patients from endemic regions; the worth of state-of-the-art diagnostic methods in atypical presentations; and the significance of examining for concurrent pulmonary involvement even in cases of extrapulmonary disease that appear to be isolated. The report bolsters existing guidelines that advocate for a multidisciplinary strategy in TB management, integrating precise microbiological diagnosis, suitable imaging, and extended antimicrobial treatment to avert long-term consequences. Clinicians working in both endemic and non-endemic areas may find these findings especially relevant, as they may come across such atypical presentations.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100543"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-14DOI: 10.1016/j.fastrc.2025.100541
William Pacheco DPM , Carly Cook DPM , Woo Y. Chun DPM , April Wong DPM , Grace Hewett MD , Marianne Bonanno MD , Don Yoo MD , Douglas Glod DPM
Charcot neuroarthropathy presents a diagnostic challenge and is complicated by chronic ulceration, as radiographic and histological findings are similar to osteomyelitis. Traditional techniques for diagnosis, such as bone biopsy and magnetic resonance imaging, lack specificity when attempting to differentiate between these two entities. In our prior case report, it was found that utilizing a comprehensive nuclear medicine imaging protocol starting with a bone scan utilizing Technetium-99 m methyl diphosphonate with single photon emission computed tomography-computed tomography (SPECT/CT) followed by an additional nuclear medicine study utilizing indium-111 labeled white blood cells and Technetium-99 m sulfur colloid with single photon emission computed tomography-computed tomography allowed differentiation between these two entities. This case series utilized this protocol and found that it allows for differentiation between these two entities even after Charcot reconstructions with chronic ulcerations. This protocol allows for improved diagnostic specificity and surgical planning for complex limb salvage.
{"title":"Novel advanced imaging method to differentiate acute osteomyelitis from acute charcot neuroarthropathy in the presence of chronic ulcer: A case series","authors":"William Pacheco DPM , Carly Cook DPM , Woo Y. Chun DPM , April Wong DPM , Grace Hewett MD , Marianne Bonanno MD , Don Yoo MD , Douglas Glod DPM","doi":"10.1016/j.fastrc.2025.100541","DOIUrl":"10.1016/j.fastrc.2025.100541","url":null,"abstract":"<div><div>Charcot neuroarthropathy presents a diagnostic challenge and is complicated by chronic ulceration, as radiographic and histological findings are similar to osteomyelitis. Traditional techniques for diagnosis, such as bone biopsy and magnetic resonance imaging, lack specificity when attempting to differentiate between these two entities. In our prior case report, it was found that utilizing a comprehensive nuclear medicine imaging protocol starting with a bone scan utilizing Technetium-99 m methyl diphosphonate with single photon emission computed tomography-computed tomography (SPECT/CT) followed by an additional nuclear medicine study utilizing indium-111 labeled white blood cells and Technetium-99 m sulfur colloid with single photon emission computed tomography-computed tomography allowed differentiation between these two entities. This case series utilized this protocol and found that it allows for differentiation between these two entities even after Charcot reconstructions with chronic ulcerations. This protocol allows for improved diagnostic specificity and surgical planning for complex limb salvage.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 3","pages":"Article 100541"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144725112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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