Probing the Validity of the Probe-to-Bone Test in the Diagnosis of Osteomyelitis of the Foot in Diabetes
- Alison Shone, BSC,
- Jaclyn Burnside, BSC,
- Susan Chipchase, BSC,
- Fran Game, FRCP and
- William Jeffcoate, MRCP
- Department of Diabetes and Endocrinology, Foot Ulcer Trials Unit, City Hospital, Nottingham, U.K.
- Address correspondence to William Jeffcoate, Foot Ulcer Trials Unit, Department of Diabetes and Endocrinology, City Hospital, Nottingham NG5 1PB, U.K. E-mail: wjeffcoate{at}futu.co.uk
The ability to probe the base of a wound to periosteum or bone (the “probe-to-bone” test) is increasingly used to indicate the likelihood of underlying osteomyelitis. The original study (1) reported sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values of 66, 85, 89, and 56%, respectively. However, this work has been criticized on the grounds of the high pretest probability of the disease (2), since the prevalence of osteomyelitis in the chosen sample (in-patients with clinically overt infection) was 66%. It follows that the usefulness of the test may be very different in less-selected populations. We have therefore determined …
