Imaging modalities of the XXXX foot.

@entity6 @entity6287 @entity4034 @entity281 @entity2719 @entity599
Charcot @entity6287 is a devastating process that occurs in the @entity6 foot. It must be distinguished from other conditions, such as @entity4034 , with efficiency and accuracy. The prognosis and treatment depends on it. Charcot progresses along four radiographically identifiable stages; therefore, plain films should be the first step in the evaluation. When @entity4034 is suspected, a three-phase bone scan may allow clear enough anatomic detail to diagnosis bony involvement compared with soft tissue in the forefoot. In the midfoot, a three-phase bone scan alone is not specific enough to distinguish between Charcot and @entity4034 . Enhancing the bone scans by adding an additional phase (four-phase) or tracer ( @entity2719 ) does not appear to improve specificity significantly. Computerized bone flow studies may be more helpful in making the distinction, particularly in acute presentation. A CT scan is not indicated because the MR image will better define the anatomic extent of the process for preoperative planning. The combined WBC scans and @entity599 colloid marrow scans show improved specificity and can distinguish between Charcot and @entity4034 . Combined leukocyte scan with bone marrow imaging is superior to leukocyte and bone scan alone or in combination for detecting @entity281 in the neuropathic foot. The combined leukocyte scan and bone marrow imaging is the current gold standard for evaluating the presence of @entity6 versus @entity6287 , and MR imagine is the anatomic gold standard that may be used to define the extent of the process.
