Correlation between clinical-imaging findings and ankle-brachial pressure index in diabetic foot ulcer

Abstract

Introduction: Diabetic foot ulcers are the main cause of amputation of the lower extremities. Its diagnosis must be timely and effective to reduce sequelae and amputations.

Objective: To correlate the clinical-imaging findings and the ankle-brachial pressure index in patients with diabetic foot ulcer.

Methods: Observational, descriptive and prospective study. Conventional radiography and Doppler-color ultrasonography and ankle-brachial index were performed on 100 patients with a clinical diagnosis of diabetic foot ulcer of the lower limbs in the period June 2018-June 2019. The following variables were taken into account: sex, age, presence of steno-occlusive pattern, ABI value, bone pattern in Rx of the foot and ultrasonographic characteristics.

Results: Of the patients studied, 61% were men and 39% were women. There were 56 patients in stages 0 to III, who showed a pathological ABI. In 75% of them, a value below 0.9 was obtained, indicative of the presence of peripheral arterial disease. Of the 55 patients in whom radiological findings were presented (arterial calcifications, neuroarthropathy and osteomyelitis), a pathological ABI was detected in 54 (98.2%). A high coincidence was evidenced between those who showed biphasic or monophasic waves and those who presented a pathological ABI value.

Conclusions: A statistically significant association of the pathological ankle-brachial index with a thickened medial intimaphase and spectral wave (biphasic, single-phase) was found. No association with radiological findings was observed.