Swiss medical weekly
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Swiss medical weekly · Jan 2012
The diagnostic value of measuring pressure pain perception in patients with diabetes mellitus.
Repetitive skin trauma and reduced pressure pain sensation are necessary components of plantar ulcer risk in patients with diabetic neuropathy. The diagnostic value of measuring pressure nociception to detect ulcer risk is, however, unknown. Instead, measuring the vibration perception threshold (VPT) by 64 Hz graduated Rydel-Seiffer tuning fork has become standard clinical practice to screen for neuropathy and ulcer proneness. We therefore set up a diagnostic case-control study to compare the VPT, the cutaneous pressure pain perception threshold (CPPPT) and the deep pressure pain perception threshold (DPPPT) at the foot sole in diabetic patients with and without past or present painless plantar ulcer. ⋯ Pressure algometry was not superior to measuring VPT for distinguishing between patients with and without painless plantar ulcers; VPT ≤1/8 was more efficient than ≤4/8 grade in identifying ulcer patients.