What is the best method to differentiate acute Charcot foot from acute infection?

Authors: Nima Heidari, Irvin Oh, Yueyang Li, Alexandros Vris, Iris Kwok, Alexander Charalambous, Ryan Rogero

RECOMMENDATION: Differentiation between acute Charcot neuroarthropathy (CN) and acute infection/osteomyelitis is complex and requires multiple (> 1) diagnostic criteria. These criteria include an emphasis on the presence of neuropathy, history and physical examination. The absence of skin wounds and resolution of swelling/erythema with elevation makes the likelihood of infection very low. In unclear cases, laboratory testing, histological examination and culturing of bone specimens, scintigraphy, and imaging, especially magnetic resonance imaging (MRI), may be of benefit.

LEVEL OF EVIDENCE: Moderate

DELEGATE VOTE: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)

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