Many prospective studies have confirmed that loss of pressure sensation using the 10-g monofilament is highly predictive of subsequent ulceration ( 3, 21, 22). Monofilaments, sometimes known as Semmes-Weinstein monofilaments, were originally used to diagnose sensory loss in leprosy ( 21). however, identification of the patient with LOPS can easily be carried out without this or other expensive equipment. The last test listed, vibration assessment using a biothesiometer or similar instrument, is widely used in the U.S. One or more abnormal tests would suggest LOPS, while at least two normal tests (and no abnormal test) would rule out LOPS. The task force agrees that any of the five tests listed could be used by clinicians to identify LOPS, although ideally two of these should be regularly performed during the screening exam-normally the 10-g monofilament and one other test. The clinical examination to identify LOPS is simple and requires no expensive equipment.įive simple clinical tests ( Table 3), each with evidence from well-conducted prospective clinical cohort studies, are considered useful in the diagnosis of LOPS in the diabetic foot ( 1– 7). The diagnosis and management of the latter were covered in a 2004 ADA technical review ( 7). The clinical exam recommended, however, is designed to identify loss of protective sensation (LOPS) rather than early neuropathy. Peripheral neuropathy is the most common component cause in the pathway to diabetic foot ulceration ( 1, 4, 5, 7).
0 Comments
Leave a Reply. |