Diagnostic Accuracy of Probe to Bone to Detect Osteomyelitis in the Diabetic Foot: A Systematic Review

Kenrick Lam; Suzanne A V van Asten; Tea Nguyen; Javier La Fontaine; Lawrence A Lavery

doi:10.1093/cid/ciw445

Diagnostic Accuracy of Probe to Bone to Detect Osteomyelitis in the Diabetic Foot: A Systematic Review

Clin Infect Dis. 2016 Oct 1;63(7):944-8. doi: 10.1093/cid/ciw445. Epub 2016 Jul 1.

Authors

Kenrick Lam¹, Suzanne A V van Asten², Tea Nguyen¹, Javier La Fontaine¹, Lawrence A Lavery¹

Affiliations

¹ Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas.
² Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.

PMID: 27369321
DOI: 10.1093/cid/ciw445

Abstract

The probe-to-bone (PTB) test is a commonly used clinical test for osteomyelitis (OM), but its utility has been questioned in clinical settings where the prevalence of OM is low. This article aims to systematically review the accuracy of the PTB test to diagnose diabetic foot OM. We searched Ovid Medline and Scopus databases for studies using the keywords "probe to bone," "osteomyelitis," and "diabetic foot" from 1946 to May 2015. We summarized characteristics of the included studies and pooled the accuracy numbers using a bivariate random-effects model. Seven studies met our inclusion criteria. Pooled sensitivity and specificity for the PTB test was 0.87 (95% confidence interval [CI], .75-.93) and 0.83 (95% CI, .65-.93), respectively. We conclude that the PTB test can accurately rule in diabetic foot OM in the high-risk patients and rule out OM in low-risk patients.

Keywords: accuracy; diabetic foot; meta-analysis; osteomyelitis; probe to bone.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Diabetic Foot / complications*
Diagnostic Techniques and Procedures
Humans
Osteomyelitis* / diagnosis
Osteomyelitis* / etiology
Sensitivity and Specificity