We conclude that the PTB test can accurately rule in diabetic foot OM in the high risk patients (ie people with high pre-test probability for having bone infection– such as hospitalized patients) and rule out osteomyelitis in low risk patients.
Congrats to our SALSAmigos Larry Lavery, Javier LaFontaine, et al.
The probe to bone test is a commonly used clinical test for osteomyelitis, but its utility has been questioned in clinical settings where the prevalence of osteomyelitis is low. This paper aims to systematically review the accuracy of the probe to bone (PTB) test to diagnose diabetic foot osteomyelitis. 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 (CI 0.75 – 0.93) and 0.83 (CI 0.65 – 0.93), respectively. We conclude that the PTB test can accurately rule in diabetic foot OM in the high risk patients and rule out osteomyelitis in low risk patients.
Clin Infect Dis. 2016 Jul 1. pii: ciw445. [Epub ahead of print] REVIEW