The DOI matches its OpenAlex record.
Probing to bone in infected pedal ulcers. A clinical sign of underlying osteomyelitis in diabetic patients
Abstract
OBJECTIVE: To assess a bedside technique for diagnosing osteomyelitis. DESIGN: We prospectively assessed infected pedal ulcers for detectable bone by probing with a sterile, blunt, stainless steel probe. We then examined the relationship between detection of bone and the presence or absence of osteomyelitis that was defined histopathologically and/or clinically. SETTING: A tertiary care center. PATIENTS: Seventy-five hospitalized diabetic patients with a total of 76 infected foot ulcers were studied. RESULTS: Osteomyelitis was diagnosed in 50 instances (66%) and was excluded in 26 instances. Bone was detected by probing in 33 of 50 ulcers with contiguous osteomyelitis; in contrast, bone was probed in only four of 26 ulcers without contiguous osteomyelitis (P < .001). Bone detected on probing was visible in only three instances. Palpating bone on probing the pedal ulcer had a sensitivity of 66% for osteomyelitis, a specificity of 85%, a positive predictive value of 89%, and a negative predictive value of 56%. CONCLUSIONS: Palpation of bone in the depths of infected pedal ulcers in patients with diabetes is strongly correlated with the presence of underlying osteomyelitis. If bone is palpated on probing, specialized roentgenographic and radionuclide tests to diagnose osteomyelitis are unnecessary. Probing for bone should be included in the initial assessment of all diabetic patients with infected pedal ulcers.
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Cited by
Lipsky, B. A., Berendt, A. R., Cornia, P. B., Pile, J. C., Peters, E. J. G., Armstrong, D. G., Deery, H. G., Embil, J. M., Joseph, W. S., Karchmer, A. W., et al. (2012) · Clinical Infectious Diseases · doi:10.1093/cid/cis346 · Cited by 1,766
Hingorani, A., LaMuraglia, G. M., Henke, P., Meissner, M. H., Loretz, L., Zinszer, K. M., Driver, V. R., Frykberg, R., Carman, T. L., Marston, W., et al. (2016) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2015.10.003 · Cited by 641
The burden of diabetic foot ulcers
Reiber, G., Lipsky, B., & Gibbons, G. (1998) · The American Journal of Surgery · doi:10.1016/s0002-9610(98)00181-0 · Cited by 527
Senneville, É., Albalawi, Z., van Asten, S. A., Abbas, Z. G., Allison, G., Aragón‐Sánchez, J., Embil, J. M., Lavery, L. A., Alhasan, M., Oz, O., et al. (2024) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3687 · Cited by 498
A Comparison of Two Diabetic Foot Ulcer Classification Systems
Oyibo, S. O., Jude, E. B., Tarawneh, I., Nguyen, H. C., Harkless, L. B., & Boulton, A. J. M. (2001) · Diabetes Care · doi:10.2337/diacare.24.1.84 · Cited by 468
Metadata
- Authors
- Grayson, M. L.
- Venue
- JAMA
- Publisher
- American Medical Association
- Published
- 1995-03-01
- Volume
- 273
- Issue
- 9
- Pages
- 721-723
- ISSN
- 0002-9955 (ISSN-L)
- OpenAlex
- W4239202478
- Cited by
- 603
- References
- 0
- FWCI
- 9.20
- Type
- journal article
- Language
- en
- Open access
- closed
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- Grayson, M. L. (1995). Probing to bone in infected pedal ulcers. A clinical sign of underlying osteomyelitis in diabetic patients. JAMA. https://doi.org/10.1001/jama.273.9.721
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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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