Inclusion Criteria:  Participants who are willing and have capacity to give informed consent People with diabetes as diagnosed by the WHO criteria Age 18 years or over New or suspected diagnosis of acute CN (no previous incidence of acute CN within the last 6 months on the same foot) treated with off-loading Understand written and verbal instructions in English  Exclusion Criteria:  People who have received a transplant and others receiving immunosuppressant therapy or using long term oral glucocorticoids other than in the routine management of glucocorticoid deficiency. Participants on a low doses of oral glucocorticoids (<10mgs for ≤7 days) are eligible to participate in the study. Participation in another intervention study on active CN Contra-indication for MRI Treatment for previous suspected CN on the same foot in the last 6 months Suspected or confirmed bilateral active CN at presentation Active osteomyelitis at randomisation Previous contralateral major amputation Inability to have an MRI scan Patients receiving palliative care