Podiatrists' Test Can Save Limbs

by Ruby Lee Gamble, News-Herald

Diabetics may now be able to avoid developing problems with heir feet thanks to the development of the Pressure Specified Sensory Device (PSSD). This new device enables podiatrists to measure the wear pattern of the feet and their level of sensitivity. This helps in the early diagnosis and treatment of diabetic foot trauma.

"This equipment has been out for a year," said Dr. Robert J. Rosenstein of Affiliated Podiatrists Inc. in Mentor. "It is completely pain-free for the patient, no needles or electrical stimulation, and it is computer-assisted for accuracy and reliability."

The American Diabetes Association and the American Association of Peripheral Neuropathy have endorsed quantitative sensory testing.

"The whole purpose of this test is to save limbs," said Rosenstein. "We want to prevent neuropathy which is the loss of sensation in the limbs. This happens to diabetics more than anyone. However, most diabetics are not aware that they should see a podiatrist once a year in order to have their feet checked for any possible symptoms of nerve damage."

By diagnosing any possible nerve damage, proper treatment can be given to prevent further problems. Diabetes is estimated to affect 5 percent of the population, and 85 percent of all diabetic amputations have diabetic neuropathy as a major contributing factor.

"A patient with diabetic neuropathy may feel tingling, numbness and/or weakness," said Rosenstein. "Loss of nerve function can result in impaired position such as hammertoe, or pain and temperature changes, making the feet susceptible to recurrent trauma without the patient's awareness. If someone with diabetes stubs their toe, it can cause an ulceration, or festering sore, which they may not feel due to the loss of sensation."

Rosenstein said the use of the PSSD to detect diabetic neuropathy could justify for insurance the cost of special footwear. The PSSD was created by A. Lee Dellon, M.D., a professor of plastic surgery and a professor of neurosurgery at the John Hopkins University School of Medicine. The PSSD works by measuring touch," said Rosenstein. "A diabetic or someone with nerve damage may not be able to feel one touch or two touches. The PSSD helps us to diagnose which nerve is causing the pain or numbness, then we can determine if the nerve can be salvaged. If a diabetic has neuropathy, they will not feel the pressure."

The PSSD doesn't just benefit diabetics, it is also good for people who come in with heel complaints.

"If treatments for a patient with heel complaints seem to have no affect, this could be an indication that there could be some nerve damage," Rosenstein said. "This device can help us detect if the patient may be suffering from tarsal tunnel syndrome, which can cause numbness and tingling." There are less than 100 PSSDs in the country. Ten or 20 of those are in Ohio. Dr. Rosenstein is one of the few podiatrists in the area who is offering this testing.

"I can't stress enough how important it is for diabetics to get tested," Rosenstein said. "This test can lessen a diabetic's chances of having severe foot trauma down the road." For more information on the Pressure-Specified Sensory Device call the Affiliated Podiatrists Inc., office at 440-946-5858.