A neurovascular foot assessment is carried out on all patients with diabetes and those patients that have poor or reduced circulation and sensation in their feet and legs.
Doppler testing is carried out as part of the assessment, this involves applying ultrasound gel to two areas of the foot (Dorsalis Pedis artery and Posterior Tibial artery) and applying the doppler probe to the skin to hear for a sound and look for a reading on the screen. The doppler ultrasound uses high frequency soundwaves to measure the amount of blood flow through the arteries. It is a great diagnostic tool in identifying blocked or narrowed arteries which can lead to conditions such as stroke.
Monofilament testing involves the use of a small probe with a standardized filament attached (feels like a piece of fishing wire) and this is pressed against part of the foot. When the filament bends, its tip is exerting a pressure of 10 grams thus, the monofilament is often referred to as the 10 gram monofilament. If the patient cannot feel the monofilament at certain specified sites on the foot, he/she has lost enough sensation to be at risk of developing foot ulcers due to the loss of protective sensation.
Vibration testing involves the use of a probe which is applied to part of the foot, usually on the big toe and other bony prominences. The probe can be made to vibrate at a high or low intensity. The person being tested indicates as soon as he/she can feel the vibration and this is recorded. Similar to the monofilament, this checks the patient’s risk of losing protective sensation.