FDG is by far the most common radiotracer used in PET/CT of bone and soft-tissue infections, with diabetic foot being the most commonly studied clinical scenario. This is more challenging diagnostically than other types of osteomyelitis, because diabetic neuropathy may lead to the development of neuropathic osteoarthropathy (Charcot joint), which can mimic osteomyelitis clinically and on radiographic and MRI studies [10]. Table 1 summarizes clinical studies over the past 2 decades on the value of FDG PET/CT for acute and subacute bone and soft-tissue infections. Overall, these studies have confirmed the value of FDG PET/CT in patients with suspected osteomyelitis, including diagnostic workup of patients with fever of unknown origin (Fig. 2). They also confirmed the ability of FDG PET/CT to differentiate osteomyelitis from its main differential considerations, including soft-tissue infections and neuropathic osteoarthropathy [3, 10–15]. There is mild diffuse hypermetabolism in neuropathic osteoarthropathy that is distinguishable from normal joints, with a maximum SUV (SUVmax) of 0.7–2.4. Normal foot articulations and uncomplicated diabetic foot both show an SUVmax of 0.2–0.8. The SUVmax of sites of osteomyelitis is typically above 2.5, with some values of up to 6.0 [10]. Patients with osteoarthropathy often also have had prior surgical intervention performed; one of the main advantages of FDG PET/CT over CT and MRI is the fact that it is not significantly affected by artifacts induced by metal implants. It is also a promising tool for treatment monitoring [14].Read More: https://www.ajronline.org/doi/full/10.2214/AJR.17.18523