scholarly journals Reliability of ultrasound in evaluating the plantar skin and fat pad of the foot in the setting of diabetes

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257790
Author(s):  
Troy Morrison ◽  
Sara Jones ◽  
Ryan Scott Causby ◽  
Kerry Thoirs

Ultrasound can be used to assess injury and structural changes to the soft-tissue structure of the foot. It may be useful to assess the feet of people with diabetes who are at increased risk of plantar soft-tissue pathological changes. The aim of this study was to determine if ultrasound measurements of plantar soft-tissue thickness and assessments of tissue acoustic characteristics are reliable in people with and without diabetes mellitus. A repeated measures design was used to determine intra-observer reliability for ultrasound measurements of plantar skin and fat pad thickness and intra- and inter-observer reliability of plantar skin and fat pad tissue characterisation assessments made at foot sites which are at risk of tissue injury in people with diabetes. Thickness measurements and tissue characterisation assessments were obtained at the heel and forefoot in both the unloaded and compressed states and included discrete layers of the plantar tissues: skin, microchamber, horizontal fibrous band, macrochamber and total soft-tissue depth. At each site, relative intra-observer reliability was achieved for the measurement of at least one plantar tissue layer. The total soft-tissue thickness measured in the unloaded state (ICC 0.925–0.976) demonstrated intra-observer reliability and is the most sensitive for detecting small change on repeated measures. Intra-observer agreement was demonstrated for tissue characteristic assessments of the skin at the heel (k = 0.70), fat pad at the lateral sesamoid region (k = 0.70) and both skin and fat pad at the second (k = 0.80, k = 0.70 respectively) and third metatarsal heads (k = 0.90, k = 0.79 respectively). However, acceptable inter-observer agreement was not demonstrated for any tissue characteristic assessment, therefore the use of multiple observers should be avoided when making these assessments.

2012 ◽  
Vol 36 (4) ◽  
pp. 405-409 ◽  
Author(s):  
SM Lee ◽  
JH Park ◽  
M Bayome ◽  
HS Kim ◽  
SS Mo ◽  
...  

Objective: To evaluate the palatal soft tissue thickness among placement sites of temporary anchorage devices (TADs) in late mixed, early permanent and permanent dentition. Materials and Method: The sample consisted of three groups; 42 late mixed dentition (mean age = 11.0 years), 41 early permanent dentition (mean age = 13.8 years), and 38 permanent dentition (mean age = 23.1 years). Soft tissue thickness was measured intraorally with an ultrasonic device using a grid of 27, 4x4 mm2 squares to delineate the measurement points. Repeated measures analysis of variance was performed to analyze the data. Results: There was a significant difference in soft tissue thickness among dentition groups with the permanent dentition group showing the highest values (P < 0.001). In each group, the thickness significantly increased from median to lateral and from anterior to posterior sites. Furthermore, the thickness showed a significant difference according to the arch form and gender (P < 0.05). However, there were no significant differences according to irregularity index and Angle classification. Conclusions: The soft tissue thickness of the palate increases from the late mixed to permanent dentition. These findings may be helpful for clinicians to enhance their successful application of TADs in the palate.


2002 ◽  
Vol 29 (11) ◽  
pp. 2687-2691 ◽  
Author(s):  
A. Pejović-Milić ◽  
J. A. Brito ◽  
J. Gyorffy ◽  
D. R. Chettle

2004 ◽  
Vol 94 (1) ◽  
pp. 39-42 ◽  
Author(s):  
Frag Abouaesha ◽  
Carine H. M. van Schie ◽  
David G. Armstrong ◽  
Andrew J. M. Boulton

The aim of this study was to evaluate whether high plantar foot pressures can be predicted from measurements of plantar soft-tissue thickness in the forefoot of diabetic patients with neuropathy. A total of 157 diabetic patients with neuropathy and at least one palpable foot pulse but without a history of foot ulceration were invited to participate in the study. Plantar tissue thickness was measured bilaterally at each metatarsal head, with patients standing on the same standardized platform. Plantar pressures were measured during barefoot walking using the optical pedobarograph. Receiver operating characteristic analysis was used to determine the plantar tissue thickness predictive of elevated peak plantar pressure. Tissue thickness cutoff values of 11.05, 7.85, 6.65, 6.55, and 5.05 mm for metatarsal heads 1 through 5, respectively, predict plantar pressure at each respective site greater than 700 kPa, with sensitivity between 73% and 97% and specificity between 52% and 84%. When tissue thickness was used to predict pressure greater than 1,000 kPa, similar results were observed, indicating that high pressure at different levels could be predicted from similar tissue thickness cutoff values. The results of the study indicate that high plantar pressure can be predicted from plantar tissue thickness with high sensitivity and specificity. (J Am Podiatr Med Assoc 94(1): 39-42, 2004)


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