A quantitative comparison of plantar soft tissue strainability distribution and homogeneity between ulcerated and non-ulcerated patients using strain elastography

The primary objective of this study was to develop a method that allows accurate quantification of plantar soft tissue stiffness distribution and homogeneity. The secondary aim of this study is to investigate if the differences in soft tissue stiffness distribution and homogeneity can be detected between ulcerated and non-ulcerated foot. Novel measures of individual pixel stiffness, named as quantitative strainability (QS) and relative strainability (RS) were developed. SE data obtained from 39 (9 with active diabetic foot ulcers) patients with diabetic neuropathy. The patients with active diabetic foot ulcer had wound in parts of the foot other than the first metatarsal head and the heel where the elastography measures were conducted. RS was used to measure changes and gradients in the stiffness distribution of plantar soft tissues in participants with and without active diabetic foot ulcer. The plantar soft tissue homogeneity in superior-inferior direction in the left forefoot was significantly (p