A new diagnostic clue to osteomyelitis in chronic leg ulcers.
Am J Med. 2015 Nov 17;
Authors: Schattner A, Dubin I, Gelber M
BACKGROUND: Chronic leg ulcers are not infrequently complicated by chronic osteomyelitis, which mandates special treatment but may not be evident on radiography. Inflammatory cytokines may cause reactive thrombocytosis in chronic osteomyelitis.
METHODS: Platelet counts were compared in a group of 24 inpatients with chronic leg ulcers and proven chronic osteomyelitis and 24 inpatients with chronic leg ulcers in whom osteomyelitis was not found.
RESULTS: Mean and median platelet counts were significantly higher in the leg ulcer and osteomyelitis group vs. the leg ulcer group (P<0.001). At a cutoff of >350X10(9)/L, sensitivity was 62.5% but specificity was 91.7% with a positive predictive value of 88%.
CONCLUSION: Thrombocytosis in chronic leg ulcers is a new, simple, readily available and inexpensive clue to osteomyelitis in chronic leg ulcers when identified, but its absence cannot rule it out.
PMID: 26597669 [PubMed - as supplied by publisher]