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Diagnostic Utility of Erythrocyte Sedimentation Rate and C-Reactive Protein in Osteomyelitis of the Foot in Persons Without Diabetes.

MedStar author(s):

Citation: Journal of Foot & Ankle Surgery. 58(3):484-488, 2019 May.PMID: 30685423Institution: MedStar Washington Hospital CenterDepartment: Surgery/Plastic SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Blood Sedimentation | *C-Reactive Protein/an [Analysis] | *Foot Diseases/di [Diagnosis] | *Osteomyelitis/di [Diagnosis] | *Soft Tissue Infections/di [Diagnosis] | Adult | Biopsy | Bone and Bones/pa [Pathology] | Cohort Studies | Diagnosis, Differential | Female | Humans | Magnetic Resonance Imaging | Male | Middle Aged | Predictive Value of Tests | Retrospective Studies | Sensitivity and Specificity | Tomography, Emission-Computed, Single-PhotonYear: 2019 Local holdings: Available online through MWHC library: 2003 - present, Available in print through MWHC library:1999-2007ISSN:

1067-2516

Name of journal: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle SurgeonsAbstract: Copyright (c) 2018. Published by Elsevier Inc.The aim of the study was to assess the diagnostic value of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels in differentiating foot osteomyelitis (OM) from soft tissue infection (STI) in persons without diabetes. We evaluated 102 patients in a retrospective cohort study of nondiabetic patients admitted to our institution with OM (n=51) and with STI (n=51). Patient diagnosis was determined through bone culture and/or histopathology for OM and magnetic resonance scan and/or single-photon emission computed tomography for STI. Cutoffs for ESR and CRP to predict OM as identified by receiver operating characteristic were 45.5 mm/h and 3.45 mg/dL, respectively. The ESR cutoff demonstrated a sensitivity and specificity of 49% and 79%, while the values for CRP were 45% and 71%, respectively. The combined sensitivity and specificity for ESR and CRP were 33% and 84%. The positive and negative predictive values were 68% and 60% for ESR and 61% and 56% for CRP, respectively. In conclusion, ESR and CRP demonstrate poor sensitivity and specificity for detecting OM in the nondiabetic foot. These markers have little diagnostic utility in the nondiabetic foot.All authors: Ahn J, Kim PJ, La Fontaine J, Lavery LA, Ryan EC, Wukich DKOriginally published: Journal of Foot & Ankle Surgery. 2019 Jan 23Fiscal year: FY2019Digital Object Identifier:

https://dx.doi.org/10.1053/j.jfas.2018.09.025

Date added to catalog: 2019-03-14

Holdings ( 1 )
Title notes ( 4 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	30685423	Available		30685423

Available online through MWHC library: 2003 - present, Available in print through MWHC library:1999-2007

The aim of the study was to assess the diagnostic value of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels in differentiating foot osteomyelitis (OM) from soft tissue infection (STI) in persons without diabetes. We evaluated 102 patients in a retrospective cohort study of nondiabetic patients admitted to our institution with OM (n=51) and with STI (n=51). Patient diagnosis was determined through bone culture and/or histopathology for OM and magnetic resonance scan and/or single-photon emission computed tomography for STI. Cutoffs for ESR and CRP to predict OM as identified by receiver operating characteristic were 45.5 mm/h and 3.45 mg/dL, respectively. The ESR cutoff demonstrated a sensitivity and specificity of 49% and 79%, while the values for CRP were 45% and 71%, respectively. The combined sensitivity and specificity for ESR and CRP were 33% and 84%. The positive and negative predictive values were 68% and 60% for ESR and 61% and 56% for CRP, respectively. In conclusion, ESR and CRP demonstrate poor sensitivity and specificity for detecting OM in the nondiabetic foot. These markers have little diagnostic utility in the nondiabetic foot.

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