MRI foot is the gold standard imaging modality for suspected osteomyelitis in diabetic foot ulcers due to its superior ability to detect bone marrow edema, differentiate soft tissue infection from bone infection, and delineate the extent of osteomyelitis. Unlike X-rays, which may show changes only in advanced cases, MRI provides early and accurate diagnosis, facilitating timely surgical planning. CT is less sensitive for marrow changes and involves radiation, while ultrasound cannot evaluate bone involvement adequately. Hence, MRI optimizes clinical decision-making for surgical debridement and antibiotic therapy in diabetic foot osteomyelitis.

Reference: Campbell-Walsh Urology, Wein AJ, 12th Edition.