Osteomyelitis: a review of diagnosis based on CRP

Abstract

In diabetic patients with foot infection, osteomyelitis shows up in 20% of cases and highly increase the probability to require a lower-extremity amputation. Unfortunately, there are no agreed guidelines for its diagnosis and early diagnosis is necessary to ensure appropriate treatment. Nevertheless, it may take several weeks for bone infection to produce defects on x-ray and bone biopsy may occasionally be misleading. MRI is the gold standard diagnostic technique for osteomyelitis (OM) but because of its low availability other noninvasive and reliable diagnostic markers are studied; within these, C reactive protein (CRP) is the principal; the levels of this protein rise highly in response of an infection. In this thesis, an initial comprehensive literature search is carried out on topics related to acute phase reactants, diabetic foot infection and diagnosis of OM. Medical records of 30 patients with bone infection who attended Medical Emergency from Diabetic Foot Unit during a period of 1,5 years are searched and studied. The aim of this study is to compare statistically serum levels of CRP to see if it is an OM indicator; moreover, to know if there is another factor, besides this mentioned, which is also altered. Finally, the validity of CRP is shown to have diagnostic value front of an OM