II. Indications

III. Exam: Monofilament

  1. Sensation triggered by 10-g Monofilament correlates with protective Sensation
  2. Technique
    1. Monofilament applied to at least 4 sites on each foot
    2. Apply just enough pressure to bend monofilament
  3. Interpretation: Unable to feel 4 sites on foot
    1. Suggests significant Peripheral Neuropathy
    2. Risk of Foot Ulcer or Charcot Joint
  4. Efficacy (low Test Sensitivity)
    1. Test Sensitivity: 53%
    2. Test Specificity: 88%
  5. References
    1. Wang (2017) J Diabetes Res 2017:8787261 +PMID: 29119118 [PubMed]

IV. Exam: Tuning Fork Test (alternative)

  1. Tuning fork (128 hz) applied to malleolus
  2. Lack of Sensation suggests Peripheral Neuropathy
  3. Less sensitive than 10-g monofilament

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