How is vibratory sense in the feet assessed in diabetic neuropathy?

Updated: Jan 08, 2019
  • Author: Dianna Quan, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Vibratory sense in the feet is tested with a 128-Hz tuning fork placed at the base of the great toenail. Test protective sensation with 5.07 Semmes-Weinstein monofilament, briefly applying the tip perpendicular to the plantar surface of the foot, using sufficient force (10 g) to buckle the monofilament. Inability to perceive the tuning fork or the monofilament identifies patients who are at increased risk (ie, 60% in the next 3 years) of developing a foot ulcer. [49] The 2 tests should be performed at least every year. [50]


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