RT Journal Article
T1 Validating the Probe-to-Bone Test and Other Tests for Diagnosing Chronic Osteomyelitis in the Diabetic Foot
A1 Morales Lozano, María Rosario
A1 González Fernández, María Luz
A1 Martínez Hernández, David
A1 Beneit Montesinos, Juan Vicente
A1 Guisado Jiménez, Sagrario
A1 González Jurado, Máximo Antonio
AB OBJECTIVE          To compare the diagnostic characteristics of tests used for a prompt diagnosis of chronic osteomyelitis in the diabetic foot, using bone histology as the criterion standard. The tests assessed were probe-to-bone (PTB), clinical signs of infection, radiography signs of osteomyelitis, and ulcer specimen culture.                  RESEARCH DESIGN AND METHODSA prospective study was performed on patients with foot ulcers referred to our diabetic foot clinic. Ulcer infection was diagnosed by recording clinical signs of infection and taking specimens for culture. The presumptive diagnosis of osteomyelitis was based on these results and the findings of a plain X-ray and PTB test. All patients with a clinical suspicion of bone infection were subjected to surgical treatment of the affected bone. During surgery, bone specimens were obtained for a histological diagnosis of osteomyelitis.          RESULTS         Over 2.5 years, 210 foot lesions were consecutively examined and 132 of these wounds with clinical suspicion of infection selected as the study sample. Of these, 105 (79.5%) lesions were diagnosed as osteomyelitis. Among the tests compared, the best results were yielded by the PTB test including an efficiency of 94%, sensitivity of 98%, specificity of 78%, positive predictive value of 95%, and negative predictive value of 91% (P < 0.001, κ 0.803); the positive likelihood ratio was 4.41, and the negative likelihood ratio was 0.02 (95% CI).           CONCLUSIONS            In our outpatient population with a high prevalence of osteomyelitis, the PTB test was of greatest diagnostic value, especially for neuropathic ulcers, and proved to be efficient for detecting osteomyelitis in the diabetic foot.
PB American Diabetes Association Inc.
SN 0149-5992
YR 2010
FD 2010-07-09
LK https://hdl.handle.net/20.500.14352/125141
UL https://hdl.handle.net/20.500.14352/125141
LA eng
NO Rosario Morales Lozano, Maria L. González Fernández, David Martinez Hernández, Juan V. Beneit Montesinos, Sagrario Guisado Jiménez, Maximo A. Gonzalez Jurado; Validating the Probe-to-Bone Test and Other Tests for Diagnosing Chronic Osteomyelitis in the Diabetic Foot. Diabetes Care 1 October 2010; 33 (10): 2140–2145. https://doi.org/10.2337/dc09-2309
DS Docta Complutense
RD 18 dic 2025