Alterations to bone mineral composition as an early indication of osteomyelitis in the diabetic foot.
Alterations to bone mineral composition as an early indication of osteomyelitis in the diabetic foot.
复制标题
骨矿物质成分的改变是糖尿病脚中骨髓炎的早期指示。
DOI：
10.2337/dc13-0510
复制
发表时间：
2013-11
期刊：
影响因子：
16.2
通讯作者：
Roessler BJ
中科院分区：
文献类型：
--
作者：
Esmonde-White KA;Esmonde-White FW;Holmes CM;Morris MD;Roessler BJ
糖尿病足骨髓炎是截肢的主要危险因素，但对早期感染的了解有限，阻碍了保肢诊断。我们假设骨成分的测量提供了深入了解糖尿病骨髓炎的早期病理生理学。通过拉曼光谱对来自临床诊断为足部骨髓炎的患者的骨标本进行成分分析，这些患者需要手术干预，如活检（n = 6）或截肢（n = 11）。一个意想不到的结果是，除了正常的骨矿物质外，还发现了病理性磷酸钙矿物质。磷酸二钙二水合物（也称为透钙磷石）和未碳酸化的磷灰石被发现只与感染的骨有关。成分测量提供了一个独特的洞察骨髓炎的病理生理学糖尿病足溃疡。通过拉曼光谱对病理性矿物质的患者现场鉴定可以作为早期诊断方法。
Osteomyelitis in the diabetic foot is a major risk factor for amputation, but there is a limited understanding of early-stage infection, impeding limb-preserving diagnoses. We hypothesized that bone composition measurements provide insight into the early pathophysiology of diabetic osteomyelitis. Compositional analysis by Raman spectroscopy was performed on bone specimens from patients with a clinical diagnosis of osteomyelitis in the foot requiring surgical intervention as either a biopsy (n = 6) or an amputation (n = 11). An unexpected result was the discovery of pathological calcium phosphate minerals in addition to normal bone mineral. Dicalcium phosphate dihydrate, also called brushite, and uncarbonated apatite were found to be exclusively associated with infected bone. Compositional measurements provided a unique insight into the pathophysiology of osteomyelitis in diabetic foot ulcers. At-patient identification of pathological minerals by Raman spectroscopy may serve as an early-stage diagnostic approach.