Evaluation of pressure threshold prior to foot ulceration: one-versus two-point static touch.
A prospective study of 29 patients with diabetic neuropathy and 47 nondiabetic patients with tarsal tunnel syndrome were evaluated with computer-assisted neurosensory testing at three sites on the foot. The sensitivity and specificity of one-point static touch thresholds for identifying the presence of large fiber axonal loss was done using the calculated thresholds for monofilaments derived from their markings. The sensitivity for one-point static touch in identifying axonal loss was 33% for the 5.07, 38% for the 4.93, 50% for the 4.17, and 60% for the 4.08 monofilament-equivalent, with a specificity of 100% at each level. Therefore, one-point static touch testing, even using monofilaments thinner than 5.07, has a high percentage of false-negative results in identifying patients with axonal loss.
Barber
M A
MA
Institute for Peripheral Nerve Surgery, Baltimore, MD, USA.
Conolley
J
J
Spaulding
C M
CM
Dellon
A L
AL
D017719:Diabetic Foot / Q000175:diagnosis* / Q000517:prevention & control; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000534:rehabilitation*; D003943:Diagnostic Techniques, Neurological; D005260:Female; D006801:Humans; D008297:Male; D017288:Pain Threshold; D011312:Pressure; D011446:Prospective Studies; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013641:Tarsal Tunnel Syndrome / Q000175:diagnosis* / Q000534:rehabilitation