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Detection of Osteomyelitis Using High Resolution Ultrasound

Primary Purpose

Chronic Osteomyelitis

Status
Unknown status
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Hitachi-Aloka Noblus ultrasound scanner
Magnetic Resonance Imaging (MRI)
Sponsored by
Calvary Hospital, Bronx, NY
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Chronic Osteomyelitis focused on measuring high resolution ultrasound, osteomyelitis

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patient may be of any race and between 18-85 years of age.
  2. Patient has a current diagnosis of a chronic ulcer with suspected osteomyelitis.
  3. Patient's ulcer may be due to any etiology including but not limited to diabetes, trauma, neuropathic, pressure, venous, arterial, and inflammatory.
  4. Patient's ulcer may extend through the dermis and into subcutaneous tissue (granulation tissue may be present), and may include exposure of muscle, tendon, bone, or joint capsule.
  5. Patient's ulcer is suspected of causing a bone infection.
  6. Patient's ulcer may be of any size.
  7. Patient's wound may present with non-viable tissue.
  8. Patient circulation to the wound should be evaluated and treated using normal protocol.
  9. Patient's diabetes is under control as determined by the Investigator. Patients must have an HbA1c value less than 13.0%. Those patients whose glucose level is not deemed to be in control should be referred to their primary physician for treatment of the hyperglycemia.
  10. Patient and caregiver are willing to participate in the clinical study and comply with the follow-up regimen.
  11. Patient or his/her legal representative has read and signed the Institutional Review Board (IRB) approved Informed Consent form before treatment.
  12. If patient is capable of childbirth, she is using medically accepted means of birth control, and she tests negative on a serum pregnancy test.
  13. Active localized acute wound infection or cellulitis: Subject may be considered for study enrollment after the signs and symptoms of acute infection have resolved.

Exclusion Criteria:

  1. Subject has a condition where an MRI is contraindicated

    • Metallic fragments, clips or devices in the brain, eye, spinal canal, etc.: (Plain radiography is sufficient for screening
    • Magnetically activated implanted devices:

    Cardiac pacemakers, insulin pumps, neuro¬stim¬u¬lators, cochlear implants, etc. may be de-programmed.

    • Non-graphite spinal cord tongs: Graphite tongs are compatible.
    • Thermodilution Swan-Ganz catheter: Local heating can result. If unenhanced MRI is likely to provide sufficient information, gadolinium should not be administered to these patients. If, after review of clinical indications, gadolinium enhancement is judged to be important for diagnosis, the lowest effective dose of contrast agent should be used.
  2. In subjects where gadolinium enhancement MRI is planned then the following exclusion criteria apply:

    • Subject is allergic to contrast materials or cannot tolerate gadolinium
    • Subject is at risk of nephrogenic systemic fibrosis (NSF) or has severe renal failure (as determined by the investigator)
  3. Patient must not be pregnant.
  4. Patient has any condition(s) that seriously compromises the patient's ability to complete this study.
  5. Patient with recent surgical debridement of the bone in and around the ulcer site.

Sites / Locations

  • Center for Curative and Palliative Wound Care, Calvary Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

High Resolution Ultrasound

Magnetic Resonance Imaging (MRI)

Arm Description

High Resolution Ultrasonography (HRUS) with a Hitachi-Aloka Noblus Scanner

Magnetic Resonance Imaging (MRI)

Outcomes

Primary Outcome Measures

Percent sensitivity and specificity of HRUS as compared to MRI and bone biopsy

Secondary Outcome Measures

Full Information

First Posted
July 22, 2014
Last Updated
July 23, 2014
Sponsor
Calvary Hospital, Bronx, NY
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1. Study Identification

Unique Protocol Identification Number
NCT02198755
Brief Title
Detection of Osteomyelitis Using High Resolution Ultrasound
Official Title
Sensitivity, Specificity and Predictive Value of High Resolution (B-Mode) Ultrasonography (HRUS) for the Detection of Osteomyelitis in Chronic Wound Patients
Study Type
Interventional

2. Study Status

Record Verification Date
July 2014
Overall Recruitment Status
Unknown status
Study Start Date
December 2014 (undefined)
Primary Completion Date
December 2015 (Anticipated)
Study Completion Date
June 2016 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Calvary Hospital, Bronx, NY

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to establish the sensitivity of HRUS as compared to MRI for the diagnosis of osteomyelitis in chronic wound patients; and to determine the specificity of HRUS as compared to pathologic and microbiologic studies of bone biopsy tissues.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Osteomyelitis
Keywords
high resolution ultrasound, osteomyelitis

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
Investigator
Allocation
Non-Randomized
Enrollment
100 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
High Resolution Ultrasound
Arm Type
Active Comparator
Arm Description
High Resolution Ultrasonography (HRUS) with a Hitachi-Aloka Noblus Scanner
Arm Title
Magnetic Resonance Imaging (MRI)
Arm Type
Active Comparator
Arm Description
Magnetic Resonance Imaging (MRI)
Intervention Type
Device
Intervention Name(s)
Hitachi-Aloka Noblus ultrasound scanner
Intervention Description
High resolution ultrasound with the Hitachi-Aloka Noblus Scanner and a 8-15mHz transducer
Intervention Type
Device
Intervention Name(s)
Magnetic Resonance Imaging (MRI)
Intervention Description
MRI with or without contrast
Primary Outcome Measure Information:
Title
Percent sensitivity and specificity of HRUS as compared to MRI and bone biopsy
Time Frame
at 3 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient may be of any race and between 18-85 years of age. Patient has a current diagnosis of a chronic ulcer with suspected osteomyelitis. Patient's ulcer may be due to any etiology including but not limited to diabetes, trauma, neuropathic, pressure, venous, arterial, and inflammatory. Patient's ulcer may extend through the dermis and into subcutaneous tissue (granulation tissue may be present), and may include exposure of muscle, tendon, bone, or joint capsule. Patient's ulcer is suspected of causing a bone infection. Patient's ulcer may be of any size. Patient's wound may present with non-viable tissue. Patient circulation to the wound should be evaluated and treated using normal protocol. Patient's diabetes is under control as determined by the Investigator. Patients must have an HbA1c value less than 13.0%. Those patients whose glucose level is not deemed to be in control should be referred to their primary physician for treatment of the hyperglycemia. Patient and caregiver are willing to participate in the clinical study and comply with the follow-up regimen. Patient or his/her legal representative has read and signed the Institutional Review Board (IRB) approved Informed Consent form before treatment. If patient is capable of childbirth, she is using medically accepted means of birth control, and she tests negative on a serum pregnancy test. Active localized acute wound infection or cellulitis: Subject may be considered for study enrollment after the signs and symptoms of acute infection have resolved. Exclusion Criteria: Subject has a condition where an MRI is contraindicated Metallic fragments, clips or devices in the brain, eye, spinal canal, etc.: (Plain radiography is sufficient for screening Magnetically activated implanted devices: Cardiac pacemakers, insulin pumps, neuro¬stim¬u¬lators, cochlear implants, etc. may be de-programmed. Non-graphite spinal cord tongs: Graphite tongs are compatible. Thermodilution Swan-Ganz catheter: Local heating can result. If unenhanced MRI is likely to provide sufficient information, gadolinium should not be administered to these patients. If, after review of clinical indications, gadolinium enhancement is judged to be important for diagnosis, the lowest effective dose of contrast agent should be used. In subjects where gadolinium enhancement MRI is planned then the following exclusion criteria apply: Subject is allergic to contrast materials or cannot tolerate gadolinium Subject is at risk of nephrogenic systemic fibrosis (NSF) or has severe renal failure (as determined by the investigator) Patient must not be pregnant. Patient has any condition(s) that seriously compromises the patient's ability to complete this study. Patient with recent surgical debridement of the bone in and around the ulcer site.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Oscar M Alvarez, PhD
Organizational Affiliation
Director, Wound Care Center, Calvary Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Martin Wendelken, DPM, RN
Organizational Affiliation
Staff Podiatrist, Wound Care Center, Calvary Hospital, Bronx, NY
Official's Role
Study Director
Facility Information:
Facility Name
Center for Curative and Palliative Wound Care, Calvary Hospital
City
Bronx
State/Province
New York
ZIP/Postal Code
10461
Country
United States
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tashara Smith, BS
Phone
718-518-2577
Email
tsmith@calvaryhospital.org
First Name & Middle Initial & Last Name & Degree
Martin Wendeken, DPM, RN
First Name & Middle Initial & Last Name & Degree
Oscar M Alvarez, PhD
First Name & Middle Initial & Last Name & Degree
Lee Markowitz, DPM

12. IPD Sharing Statement

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Detection of Osteomyelitis Using High Resolution Ultrasound

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