Check list of items in confluence? Click and ... bam - tickets where you can track discussion, media, code, etc. Link back to the definition doc, and the doc has a status view of the ticket(s).
I've wondered if they've got some patent on this which has prevented other folks from replicating it. Or... is everyone else so focused on "disparate tools that talk to each other" that this tie in has never made it on anyone's radar?
If this was in redmine (for example) - having the wiki be aware of the ticket system - that would be great.