Ettore Squillaci MD, Presenter: Nothing to Disclose

Francesca Bolacchi, Abstract Co-Author: Nothing to Disclose

Marco Antonicoli, Abstract Co-Author: Nothing to Disclose

Simone Altobelli, Abstract Co-Author: Nothing to Disclose

Marco Nezzo MD, Abstract Co-Author: Nothing to Disclose

Giovanni Simonetti MD, Abstract Co-Author: Nothing to Disclose

Charcot osteo-arthropathy (COA) occurs in the foot/ankle in diabetic patients with sensory neuropathy and it is a common cause of morbidity in this population. Although local clinical signs are useful indicators of disease activity, they are affected by poor sensibility and reproducibility. We aimed to evaluate whether bone marrow 1H magnetic resonance spectroscopy (MRS) might provide a quantitative parameter able to assess disease activity in acute CN.

Twenty two diabetic patients with stage 0 CN were prospectively evaluated at clinical onset and during treatment follow-up. The MRS lipid spectrum was analysed and a lipid polyunsaturation index (PUI) was calculated. Disease recovery was defined as the disappearance of bone marrow oedema as demonstrated on MRI short-tau-inversion-recovery (STIR) images. A 3-T MRI was used.

Inter and intra-individual PUI measurements generated reproducible results with approximately 7% and 6% variation respectively. Baseline PUI values were significantly higher in patients with acute CN compared with controls. Also, a significant positive correlation was observed between baseline PUI values and serum levels of IL-6 and TNF-α. During follow-up a gradual decrease in PUI was observed. The percentage reduction of PUI values at 3 months’ follow-up with respect to baseline values showed a negative correlation with recovery time.

Bone marrow MRS provides a measurable index that allows progressive evaluation of disease activity in acute COA. MRS may be a complementary tool that can be used to guide clinicians in the management of acute COA patients.

Bone marrow 1H-MRS provides biomarkers of disease activity in acute Charcot osteo-arthropathy.

Squillaci, E, Bolacchi, F, Antonicoli, M, Altobelli, S, Nezzo, M, Simonetti, G, Bone Marrow 3T Proton MR Spectroscopy Provides Biomarkers of Disease Activity in Acute Charcot Osteo-arthropathy.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14010325.html