Imaging of the diabetic foot aims primarily to define and grade the anatomical deformity, and to rule out infection. Direct radiographs are the basis of preliminary imaging; however, magnetic resonance imaging (MRI) has proved to be a better modality due to its high resolution for soft-tissues.
Main purpose of imaging is to differentiate neuropathic arthropathy from infection. Neuropathic arthropathy causes MRI signal changes and deformities initially in bony structures, and progress with periarticular inflammation; while infection requires the presence of a callus or ulcer that causes loss of skin integrity. MRI may also demonstrate necrotic bony fragments as well as abscesses and fistulous tracts. Changes in signal intensity of muscular tissue may occur secondary to rare complications like myositis and ischaemia.