Table 1.
Laboratory diagnostic studies
| Weiner et al. (25) | Compared histology and microbiology diagnosis pedal osteomyelitis in diabetic patients | Results positive microbiologic and negative histological just as likely as negative microbiologic and positive histological | Microbiologic testing performed as well as histological testing in identifying pedal osteomyelitis diabetic foot |
| Senneville et al. (26) | Diagnostic value swab cultures compared to cultures of percutaneous bone biopsy for diabetic foot osteomyelitis | Bone and swab cultures identical for 17.4% patients, bone bacteria isolated from corresponding swab culture 30.4%. The overall concordance for all isolates 22.5% | Superficial swab cultures do not reliably identify bone bacteria |
| Senneville et al. (27) | Outcome diabetic patients suspicion osteomyelitis foot undergone percutaneous bone biopsy that yielded negative microbiological results | Diabetic patient with suspicion osteomyelitis and negative percutaneous bone biopsy, 1:4 develop osteomyelitis within 2 years of biopsy | |
| Senneville at al. (28) | Compared needle puncture with concomitant transcutaneous bone biopsy | 67.7% bone biopsy, 58% needle puncture, 96.7% swab positive culture results. Staphylococcus aureus most common type of bacteria that grew from bone samples, bone biopsy and needle puncture specimens identical 32.3% | Needle punctures compared with transcutaneous bone biopsies, do not identify bone bacteria reliably |
| Aragón-Sánchez et al. (29) | Investigated accuracy sequential combination probe-to-bone and plain x-rays diagnosing osteomyelitis | 72.4% histologically proven osteomyelitis, 85.2% of which positive bone culture, sequential diagnostic sensitivity of 0.97, specificity of 0.92. | Clinicians can confidently diagnose diabetic foot osteomyelitis when both the probe-to-bone test and plain x-ray positive. |
| Lavery et al. (24) | Investigated probe to bone for identification of osteomyelitis | 1,666 diabetic patients, probe to bone test positive predictive value 57% and negative predictive value 98% | Positive probe to bone test increases probability osteomyelitis slightly greater than 50%, negative probe to bone test strong predictor absence bone infection |