Grading Fractures on Foot and Ankle X-rays and MRI Scans in the Active Charcot Foot in Diabetes: How Strong Is the Agreement Between Modalities?
Authors' conclusion
The significant underperformance of X-ray in the assessment of the hot, swollen foot in diabetes should be considered when confirming or refuting the diagnosis of active CNO.
Study context
- Population
- People with diabetes and active Charcot neuro-osteoarthropathy (CNO)
- Participants
- 48 people
- Comparison
- X-ray vs MRI for grading fractures and detecting bone injury in active CNO
- Outcome
- Agreement between X-ray and MRI (tests for symmetry, marginal homogeneity, κ-coefficients)
Performance
As reported in the abstract
Κ (fracture severity grading)
0.53
P < 0.001
moderate to substantial agreement
Κ (detecting bone injury)
0.17
P < 0.001
slight to fair agreement
- X-ray underscored MRI in grading fractures in the metatarsals
- P = 0.05
- X-ray underscored MRI in grading fractures in the tarsals
- P < 0.001
- Bones with bone marrow edema (BME) reported as normal on X-ray
- 79%
Original publication
Grading Fractures on Foot and Ankle X-rays and MRI Scans in the Active Charcot Foot in Diabetes: How Strong Is the Agreement Between Modalities? Diabetes Care. Published 12 July 2023. doi:10.
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