DIABETIC FOOT: CORRELATION BETWEEN CLINICAL ABNORMALITIES AND ELECTROPHYSIOLOGICAL STUDIES

Abstract

Diabetic foot ulceration is a serious and expensive complication with considerable morbidity that affects up to 15% of diabetic patients during their lifetime and 80-85% of amputations are preceded by foot ulcers. The aim of this work is to study the correlation between severity of clinical abnormalities and electrophysiological studies in diabetic foot ulcers. This study was a cross sectional evaluation of 44 patients with diabetic foot ulcers seen in 2 hospitals in Basrah (Al-Faiha General and Basrah Teaching) from October 2003 to July 2004. All patients were type 2 diabetes mellitus. The sensitivity of numbness, burning feeling, pricking feeling and worse symptom at night was 84.6%, 69.2%, 61.5% and 51.5% respectively. While sensitivity of decreased pin prick sensation, absent vibration sense, absent ankle jerk, decreased temperature sensations and absent position sense was 100%, 87.2%, 71.8%, 56.5% and 12.8% respectively. Sensitivity of combined clinical symptoms was 66.6%, with specificity of 40%, and predictive value of 89.6% while that of clinical signs 48.7% and 60% respectively and predictive value of 90.4 %. There was no significant difference in severity of electrophysiological abnormalities in the affected and non-affected feet. Clinical findings was correlated well with the severity of electrophysiological changes in patients with diabetic foot ulcers.