Radiologic changes of ulcerated foot in leprosy.

There are radiologically characteristic bone changes on the foot and tarsus in leprosy. The bone changes areprimarily due to Mycobacterium leprae infection and secondarily to the injurious effect, such as trauma, andinfection on the denervated tissue. 117 bone changes fo 100 leprosy patients with plantar ulcerations from Jan.1984 to Oct. 1989 in the Korean Leprosy Control Center were analyzed. Male to female ratio was about 2:1 and themost prevalent age was 41 to 60 years, and according to Ridley-Jopling's classification. L-type was most common(46%). One hundred and eleven cases (94.9%) showed bone changes, suggesting high incidence of bone changes inpatients with plantar ulcers. Specific changes were observed in two cases(1.7%). One hundred and nine cases showednonspecific bone changes, which were osteomyelitis(23.1%), neurotrophic changes(39.3%), periostitis(5.1%) andarthritis(12.8%). Extensive bone involvement was seen in neurotrophic changes involving forefoot and metatarsal in22 of 46 cases, and in secondary changes involving forefoot and metatarsal in 22 of 46 cases, and in secondarychanges involving metatarsal bone in 23, tarsus in 20 of 49 cases.