Abstract: Diabetic foot is one of the common and severe complications faced by diabetic patients, primarily caused by neuropathy and peripheral arterial disease. As the disease progresses, patients gradually develop diabetic foot infections and diabetic foot osteomyelitis（DFO）, the latter often necessitating lower limb amputation, which severely impacts the quality of life of patients. Imaging examinations play a crucial role in the early diagnosis of DFO. X-rays have certain value in initial screening and follow-up, while MRI offers higher accuracy and sensitivity in diagnosing DFO, although there are contraindications for the examination. 18F-fluorodeoxyglucose positron emission tomography/computed tomography（18F-FDG PET/CT）has high sensitivity. However, its high cost and relatively low clinical prevalence somewhat limit its widespread clinical application. In comparison, single-photon emission computed tomography/computed tomography (SPECT/CT) combining different technologies offers a more convenient and safe option for diagnosing DFO, and can effectively evaluate the location and extent of the infection. Ultrasound examination has the advantages of high clinical prevalence and lower examination costs, but its diagnostic efficacy largely depends on the operator's experience, leading to considerable variability. Additionally, dual-energy CT (DECT), as an emerging imaging technology, has shown promising diagnostic potential in the midfoot and hindfoot regions. This article summarizes the indications, diagnostic efficacy, and clinical limitations of various imaging examination methods reported in recent literature for the diagnosis of DFO, aiming to provide clinicians with a reference for selecting appropriate imaging examination methods, thereby improving the early diagnosis rate of DFO and enhancing patient prognosis.

Key words: Diabetic foot, Diabetic foot osteomyelitis, Imaging