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Pathomorphological analysis in the diagnosis of diabetic foot osteomyelitis

[Morphology]
Tatiana Anatolyevna Stupina; Tatiana Nikolaevna Varsegova; Nikolay Sergeevich Migalkin; Anatoly Sergeevich Sudnitsyn;

The operation material (fragments of the calcaneus, the talus, as well as those of metatarsal bones, bones of toe phalanges, skin) from 12 patients with the diabetic foot syndrome was studied. The study was performed using «AxioScope. A1» microscope (CarlZeissMicroImagingGmbH, Germany) and «VT-Master-Morphology» («VideoTest», Russia). There were osteonecrosis foci revealed in bone tissue, the replacement of bone marrow structures with granulation tissue and fibrosis, inflammatory infiltrate, signs of reparative osteogenesis. Bone inflammation was active (subacute and acute process of chronic osteomyelitis) in most patients (83 %) with involvement of one (68 %), two or three bones (42 %). Signs of mycotic microflora revealed in one patient. Signs of pseudocarcinomatous hyperplasia were specific for all the skin specimen, as well as those of chronic inflammation, innervation and blood supply disorder, high mitotic activity of epidermal basal layer cells. The revealed pathomorphological characteristics of diabetic foot bones and skin in patients with chronic osteomyelitis supplement the data of other general clinical research methods, allow the clinician to form a final diagnosis and substantiate the choice of treatment variant for this category of patients.

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Keywords: chronic osteomyelitis, diabetic foot, pathomorphology, bone tissue, skin


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