BedBiopsy: Diagnostic performance of bedside ultrasound-guided bone biopsies for the management of diabetic foot infection
We aimed to assess the feasibility and diagnostic performance of ultrasound-guided bone biopsies at the bedside of diabetic patients admitted for suspected foot osteitis not requiring surgery. In this retrospective monocentric study, we compared the performance of ultrasound-guided (n = 29 consecuti...
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| Veröffentlicht in: | Diabetes & metabolism 2024-05, Vol.50 (3), p.101525-101525, Article 101525 |
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| creator | Hassold, Nolan Bihan, Hélène Moumba, Yolène Pambo Poilane, Isabelle Méchaï, Frédéric Assad, Nabil Labbe-Gentils, Véronique Sal, Meriem Koutcha, Omar Nouhou Martin, Antoine Radu, Dana Martinod, Emmanuel Cordel, Hugues Vignier, Nicolas Tatulashvili, Sopio Berkane, Narimane Carbonnelle, Etienne Bouchaud, Olivier Cosson, Emmanuel |
| description | We aimed to assess the feasibility and diagnostic performance of ultrasound-guided bone biopsies at the bedside of diabetic patients admitted for suspected foot osteitis not requiring surgery.
In this retrospective monocentric study, we compared the performance of ultrasound-guided (n = 29 consecutive patients, Dec.2020-Oct.2022) versus surgical (n = 24 consecutive patients, Jan.2018-Nov.2020) bone biopsies at confirming or ruling out diabetic foot osteitis (primary outcome).
Patient characteristics were similar in the two intervention groups, including arteritis prevalence (62.3 %), SINBAD score, and wound location (phalanges 36 %, metatarsus 43 %, and calcaneus 21 %). However, the ultrasound-guided group was older (67 ± 11 versus 60 ± 13 years respectively, P = 0.047) and had more type 2 diabetes (97 % versus 75 %, P = 0.038). Diagnostic performance (i.e., capacity to confirm or rule out suspected osteitis) was similar for ultrasound-guided (28/29 cases: 25 confirmations, 3 invalidations) and surgical (24 confirmations/24) biopsies, P = 0.358. No biopsy-related side effect or complication was observed for either intervention, even for patients on antiaggregation and/or anticoagulation therapy. The mean (± standard deviation) time necessary to perform the biopsy was shorter in the ultrasound-guided group (2.6 ± 3.0 versus 7.2 ± 5.8 days, respectively, P < 0.001) and wound evolution at three months was more favorable (83.3 versus 41.2 %, P = 0.005) (94.4 % versus 66.7 %, respectively, patients with new surgical procedure within six months excluded; P = 0.055). Even though not statistically significant, healing rates in terms of wound and osteitis at six months were also better in the ultrasound-guided group (wound: 40.9 % versus 36.8 %; P = 0.790, and osteitis: 81.8 vs 55.6 % P = 0.071).
In diabetic patients with suspected foot osteitis not requiring surgery, bedside ultrasound-guided bone biopsies may constitute a promising alternative to surgical biopsies. This intervention provided excellent tolerance and microbiological documentation, short lead-times, and more favorable wound prognosis. |
| doi_str_mv | 10.1016/j.diabet.2024.101525 |
| format | Article |
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In this retrospective monocentric study, we compared the performance of ultrasound-guided (n = 29 consecutive patients, Dec.2020-Oct.2022) versus surgical (n = 24 consecutive patients, Jan.2018-Nov.2020) bone biopsies at confirming or ruling out diabetic foot osteitis (primary outcome).
Patient characteristics were similar in the two intervention groups, including arteritis prevalence (62.3 %), SINBAD score, and wound location (phalanges 36 %, metatarsus 43 %, and calcaneus 21 %). However, the ultrasound-guided group was older (67 ± 11 versus 60 ± 13 years respectively, P = 0.047) and had more type 2 diabetes (97 % versus 75 %, P = 0.038). Diagnostic performance (i.e., capacity to confirm or rule out suspected osteitis) was similar for ultrasound-guided (28/29 cases: 25 confirmations, 3 invalidations) and surgical (24 confirmations/24) biopsies, P = 0.358. No biopsy-related side effect or complication was observed for either intervention, even for patients on antiaggregation and/or anticoagulation therapy. The mean (± standard deviation) time necessary to perform the biopsy was shorter in the ultrasound-guided group (2.6 ± 3.0 versus 7.2 ± 5.8 days, respectively, P < 0.001) and wound evolution at three months was more favorable (83.3 versus 41.2 %, P = 0.005) (94.4 % versus 66.7 %, respectively, patients with new surgical procedure within six months excluded; P = 0.055). Even though not statistically significant, healing rates in terms of wound and osteitis at six months were also better in the ultrasound-guided group (wound: 40.9 % versus 36.8 %; P = 0.790, and osteitis: 81.8 vs 55.6 % P = 0.071).
In diabetic patients with suspected foot osteitis not requiring surgery, bedside ultrasound-guided bone biopsies may constitute a promising alternative to surgical biopsies. This intervention provided excellent tolerance and microbiological documentation, short lead-times, and more favorable wound prognosis.</description><identifier>ISSN: 1262-3636</identifier><identifier>EISSN: 1878-1780</identifier><identifier>DOI: 10.1016/j.diabet.2024.101525</identifier><identifier>PMID: 38442769</identifier><language>eng</language><publisher>France: Elsevier Masson SAS</publisher><subject>Aged ; Bone and Bones - diagnostic imaging ; Bone and Bones - pathology ; Bone biopsy ; Diabetic Foot - diagnostic imaging ; Diabetic foot infection ; Effectiveness ; Female ; Humans ; Image-Guided Biopsy - methods ; Male ; Middle Aged ; Osteitis ; Retrospective Studies ; Ultrasonography, Interventional - methods</subject><ispartof>Diabetes & metabolism, 2024-05, Vol.50 (3), p.101525-101525, Article 101525</ispartof><rights>2024 The Author(s)</rights><rights>Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-3bafe96ac4f392324b9649aee8e9c24e09191acb0151209f30ec2a5f1c6922b23</citedby><cites>FETCH-LOGICAL-c408t-3bafe96ac4f392324b9649aee8e9c24e09191acb0151209f30ec2a5f1c6922b23</cites><orcidid>0000-0003-0944-4997</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S126236362400017X$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38442769$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hassold, Nolan</creatorcontrib><creatorcontrib>Bihan, Hélène</creatorcontrib><creatorcontrib>Moumba, Yolène Pambo</creatorcontrib><creatorcontrib>Poilane, Isabelle</creatorcontrib><creatorcontrib>Méchaï, Frédéric</creatorcontrib><creatorcontrib>Assad, Nabil</creatorcontrib><creatorcontrib>Labbe-Gentils, Véronique</creatorcontrib><creatorcontrib>Sal, Meriem</creatorcontrib><creatorcontrib>Koutcha, Omar Nouhou</creatorcontrib><creatorcontrib>Martin, Antoine</creatorcontrib><creatorcontrib>Radu, Dana</creatorcontrib><creatorcontrib>Martinod, Emmanuel</creatorcontrib><creatorcontrib>Cordel, Hugues</creatorcontrib><creatorcontrib>Vignier, Nicolas</creatorcontrib><creatorcontrib>Tatulashvili, Sopio</creatorcontrib><creatorcontrib>Berkane, Narimane</creatorcontrib><creatorcontrib>Carbonnelle, Etienne</creatorcontrib><creatorcontrib>Bouchaud, Olivier</creatorcontrib><creatorcontrib>Cosson, Emmanuel</creatorcontrib><title>BedBiopsy: Diagnostic performance of bedside ultrasound-guided bone biopsies for the management of diabetic foot infection</title><title>Diabetes & metabolism</title><addtitle>Diabetes Metab</addtitle><description>We aimed to assess the feasibility and diagnostic performance of ultrasound-guided bone biopsies at the bedside of diabetic patients admitted for suspected foot osteitis not requiring surgery.
In this retrospective monocentric study, we compared the performance of ultrasound-guided (n = 29 consecutive patients, Dec.2020-Oct.2022) versus surgical (n = 24 consecutive patients, Jan.2018-Nov.2020) bone biopsies at confirming or ruling out diabetic foot osteitis (primary outcome).
Patient characteristics were similar in the two intervention groups, including arteritis prevalence (62.3 %), SINBAD score, and wound location (phalanges 36 %, metatarsus 43 %, and calcaneus 21 %). However, the ultrasound-guided group was older (67 ± 11 versus 60 ± 13 years respectively, P = 0.047) and had more type 2 diabetes (97 % versus 75 %, P = 0.038). Diagnostic performance (i.e., capacity to confirm or rule out suspected osteitis) was similar for ultrasound-guided (28/29 cases: 25 confirmations, 3 invalidations) and surgical (24 confirmations/24) biopsies, P = 0.358. No biopsy-related side effect or complication was observed for either intervention, even for patients on antiaggregation and/or anticoagulation therapy. The mean (± standard deviation) time necessary to perform the biopsy was shorter in the ultrasound-guided group (2.6 ± 3.0 versus 7.2 ± 5.8 days, respectively, P < 0.001) and wound evolution at three months was more favorable (83.3 versus 41.2 %, P = 0.005) (94.4 % versus 66.7 %, respectively, patients with new surgical procedure within six months excluded; P = 0.055). Even though not statistically significant, healing rates in terms of wound and osteitis at six months were also better in the ultrasound-guided group (wound: 40.9 % versus 36.8 %; P = 0.790, and osteitis: 81.8 vs 55.6 % P = 0.071).
In diabetic patients with suspected foot osteitis not requiring surgery, bedside ultrasound-guided bone biopsies may constitute a promising alternative to surgical biopsies. This intervention provided excellent tolerance and microbiological documentation, short lead-times, and more favorable wound prognosis.</description><subject>Aged</subject><subject>Bone and Bones - diagnostic imaging</subject><subject>Bone and Bones - pathology</subject><subject>Bone biopsy</subject><subject>Diabetic Foot - diagnostic imaging</subject><subject>Diabetic foot infection</subject><subject>Effectiveness</subject><subject>Female</subject><subject>Humans</subject><subject>Image-Guided Biopsy - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Osteitis</subject><subject>Retrospective Studies</subject><subject>Ultrasonography, Interventional - methods</subject><issn>1262-3636</issn><issn>1878-1780</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtOHDEQRa0IFAjhD6LISzY9-NU97SwiweQBEhIbsrb8KE88mm5PbDcS-XrcamDJqkqle29VHYS-ULKihHaXu5UL2kBZMcLEPGpZ-wGd0n7dN3Tdk6Pas441vOPdCfqU844QyiTvP6IT3gvB1p08Rf-vwV2HeMhP3_CPoLdjzCVYfIDkYxr0aAFHjw24HBzgaV-SznEaXbOd6sBhE0fAZg4IkHH14PIXcDXqLQwwltm93FlTfYwFh9GDLSGOn9Gx1_sM5y_1DP359fNhc9Pc3f--3VzdNVaQvjTcaA-y01Z4LhlnwshOSA3Qg7RMAJFUUm1NBUAZkZ4TsEy3ntpOMmYYP0MXS-4hxX8T5KKGkC3s93qEOGU1M2G9aFtepWKR2hRzTuDVIYVBpydFiZqpq51avlEzdbVQr7avLxsmM4B7M71iroLviwDqn48Bkso2QIXrQqowlIvh_Q3PwEmWsQ</recordid><startdate>202405</startdate><enddate>202405</enddate><creator>Hassold, Nolan</creator><creator>Bihan, Hélène</creator><creator>Moumba, Yolène Pambo</creator><creator>Poilane, Isabelle</creator><creator>Méchaï, Frédéric</creator><creator>Assad, Nabil</creator><creator>Labbe-Gentils, Véronique</creator><creator>Sal, Meriem</creator><creator>Koutcha, Omar Nouhou</creator><creator>Martin, Antoine</creator><creator>Radu, Dana</creator><creator>Martinod, Emmanuel</creator><creator>Cordel, Hugues</creator><creator>Vignier, Nicolas</creator><creator>Tatulashvili, Sopio</creator><creator>Berkane, Narimane</creator><creator>Carbonnelle, Etienne</creator><creator>Bouchaud, Olivier</creator><creator>Cosson, Emmanuel</creator><general>Elsevier Masson SAS</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0944-4997</orcidid></search><sort><creationdate>202405</creationdate><title>BedBiopsy: Diagnostic performance of bedside ultrasound-guided bone biopsies for the management of diabetic foot infection</title><author>Hassold, Nolan ; Bihan, Hélène ; Moumba, Yolène Pambo ; Poilane, Isabelle ; Méchaï, Frédéric ; Assad, Nabil ; Labbe-Gentils, Véronique ; Sal, Meriem ; Koutcha, Omar Nouhou ; Martin, Antoine ; Radu, Dana ; Martinod, Emmanuel ; Cordel, Hugues ; Vignier, Nicolas ; Tatulashvili, Sopio ; Berkane, Narimane ; Carbonnelle, Etienne ; Bouchaud, Olivier ; Cosson, Emmanuel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-3bafe96ac4f392324b9649aee8e9c24e09191acb0151209f30ec2a5f1c6922b23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Bone and Bones - diagnostic imaging</topic><topic>Bone and Bones - pathology</topic><topic>Bone biopsy</topic><topic>Diabetic Foot - diagnostic imaging</topic><topic>Diabetic foot infection</topic><topic>Effectiveness</topic><topic>Female</topic><topic>Humans</topic><topic>Image-Guided Biopsy - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Osteitis</topic><topic>Retrospective Studies</topic><topic>Ultrasonography, Interventional - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hassold, Nolan</creatorcontrib><creatorcontrib>Bihan, Hélène</creatorcontrib><creatorcontrib>Moumba, Yolène Pambo</creatorcontrib><creatorcontrib>Poilane, Isabelle</creatorcontrib><creatorcontrib>Méchaï, Frédéric</creatorcontrib><creatorcontrib>Assad, Nabil</creatorcontrib><creatorcontrib>Labbe-Gentils, Véronique</creatorcontrib><creatorcontrib>Sal, Meriem</creatorcontrib><creatorcontrib>Koutcha, Omar Nouhou</creatorcontrib><creatorcontrib>Martin, Antoine</creatorcontrib><creatorcontrib>Radu, Dana</creatorcontrib><creatorcontrib>Martinod, Emmanuel</creatorcontrib><creatorcontrib>Cordel, Hugues</creatorcontrib><creatorcontrib>Vignier, Nicolas</creatorcontrib><creatorcontrib>Tatulashvili, Sopio</creatorcontrib><creatorcontrib>Berkane, Narimane</creatorcontrib><creatorcontrib>Carbonnelle, Etienne</creatorcontrib><creatorcontrib>Bouchaud, Olivier</creatorcontrib><creatorcontrib>Cosson, Emmanuel</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes & metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hassold, Nolan</au><au>Bihan, Hélène</au><au>Moumba, Yolène Pambo</au><au>Poilane, Isabelle</au><au>Méchaï, Frédéric</au><au>Assad, Nabil</au><au>Labbe-Gentils, Véronique</au><au>Sal, Meriem</au><au>Koutcha, Omar Nouhou</au><au>Martin, Antoine</au><au>Radu, Dana</au><au>Martinod, Emmanuel</au><au>Cordel, Hugues</au><au>Vignier, Nicolas</au><au>Tatulashvili, Sopio</au><au>Berkane, Narimane</au><au>Carbonnelle, Etienne</au><au>Bouchaud, Olivier</au><au>Cosson, Emmanuel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>BedBiopsy: Diagnostic performance of bedside ultrasound-guided bone biopsies for the management of diabetic foot infection</atitle><jtitle>Diabetes & metabolism</jtitle><addtitle>Diabetes Metab</addtitle><date>2024-05</date><risdate>2024</risdate><volume>50</volume><issue>3</issue><spage>101525</spage><epage>101525</epage><pages>101525-101525</pages><artnum>101525</artnum><issn>1262-3636</issn><eissn>1878-1780</eissn><abstract>We aimed to assess the feasibility and diagnostic performance of ultrasound-guided bone biopsies at the bedside of diabetic patients admitted for suspected foot osteitis not requiring surgery.
In this retrospective monocentric study, we compared the performance of ultrasound-guided (n = 29 consecutive patients, Dec.2020-Oct.2022) versus surgical (n = 24 consecutive patients, Jan.2018-Nov.2020) bone biopsies at confirming or ruling out diabetic foot osteitis (primary outcome).
Patient characteristics were similar in the two intervention groups, including arteritis prevalence (62.3 %), SINBAD score, and wound location (phalanges 36 %, metatarsus 43 %, and calcaneus 21 %). However, the ultrasound-guided group was older (67 ± 11 versus 60 ± 13 years respectively, P = 0.047) and had more type 2 diabetes (97 % versus 75 %, P = 0.038). Diagnostic performance (i.e., capacity to confirm or rule out suspected osteitis) was similar for ultrasound-guided (28/29 cases: 25 confirmations, 3 invalidations) and surgical (24 confirmations/24) biopsies, P = 0.358. No biopsy-related side effect or complication was observed for either intervention, even for patients on antiaggregation and/or anticoagulation therapy. The mean (± standard deviation) time necessary to perform the biopsy was shorter in the ultrasound-guided group (2.6 ± 3.0 versus 7.2 ± 5.8 days, respectively, P < 0.001) and wound evolution at three months was more favorable (83.3 versus 41.2 %, P = 0.005) (94.4 % versus 66.7 %, respectively, patients with new surgical procedure within six months excluded; P = 0.055). Even though not statistically significant, healing rates in terms of wound and osteitis at six months were also better in the ultrasound-guided group (wound: 40.9 % versus 36.8 %; P = 0.790, and osteitis: 81.8 vs 55.6 % P = 0.071).
In diabetic patients with suspected foot osteitis not requiring surgery, bedside ultrasound-guided bone biopsies may constitute a promising alternative to surgical biopsies. This intervention provided excellent tolerance and microbiological documentation, short lead-times, and more favorable wound prognosis.</abstract><cop>France</cop><pub>Elsevier Masson SAS</pub><pmid>38442769</pmid><doi>10.1016/j.diabet.2024.101525</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0003-0944-4997</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Bone and Bones - diagnostic imaging Bone and Bones - pathology Bone biopsy Diabetic Foot - diagnostic imaging Diabetic foot infection Effectiveness Female Humans Image-Guided Biopsy - methods Male Middle Aged Osteitis Retrospective Studies Ultrasonography, Interventional - methods |
| title | BedBiopsy: Diagnostic performance of bedside ultrasound-guided bone biopsies for the management of diabetic foot infection |
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