Diabetic neuropathy physical examination

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Diabetic neuropathy Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Physical Examination

A study by the International Cooperative Group for Clinical Examination Research found that the monofilament and reflex testing were the most reproducible[1]. This study also found that monofilament testing of four locations per foot was adequate.

A systematic review by the Rational Clinical Examination found that "Abnormal results on monofilament testing and vibratory perception (alone or in combination with the appearance of the feet, ulceration, and ankle reflexes) are the most helpful signs"[2].

Images

(Images courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, California)

References

  1. Smieja M, Hunt DL, Edelman D, Etchells E, Cornuz J, Simel DL (1999). "Clinical examination for the detection of protective sensation in the feet of diabetic patients. International Cooperative Group for Clinical Examination Research". J Gen Intern Med. 14 (7): 418–24. doi:10.1046/j.1525-1497.1999.05208.x. PMC 1496604. PMID 10417599.
  2. Kanji JN, Anglin RE, Hunt DL, Panju A (2010). "Does this patient with diabetes have large-fiber peripheral neuropathy?". JAMA. 303 (15): 1526–32. doi:10.1001/jama.2010.428. PMID 20407062. Review in: Ann Intern Med. 2010 Oct 19;153(8):JC4-10

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