期刊
DIABETES CARE
卷 36, 期 11, 页码 3652-3654出版社
AMER DIABETES ASSOC
DOI: 10.2337/dc13-0510
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资金
- National Institute of Arthritis and Musculoskeletal and Skin Diseases [T32-AR-007080, R01-AR-055222, R01-AR-047969]
- Michigan Institute of Clinical and Health Research [UL1RR024986]
- National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health [R21-EB-101026]
OBJECTIVEOsteomyelitis 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.RESEARCH DESIGN AND METHODSCompositional 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).RESULTSAn 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.CONCLUSIONSCompositional 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.
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