Diabetic Foot Examination

Question 1

What is the following clinical sign and what does it indicate?

Answer 1

Venous guttering: veins that have very little blood within them due to poor blood supply to the limb, hence the “guttered” appearance

Question 2

What is Charcot arthropathy?

Answer 2

Charcot arthropathy

Charcot arthropathy involves the progressive degeneration of a weight-bearing joint due to peripheral neuropathy.

The typical clinical features of a Charcot’s joint include:

Effusion

Distortion

Overlying erythema

Loss of joint function

Question 3

What further investigations/examinations will you do?

Answer 3

Further assessments and investigations

Suggest further assessments and investigations to the examiner:

Bedside capillary blood glucose: if there is concern that the patient is currently hyperglycaemic or hypoglycaemic.

Serum HbA1c: to aid assessment of blood glucose control over the previous three months.

Lower limb neurological examination: if diabetic foot examination reveals neurological deficits.

Peripheral arterial examination: if diabetic foot examination identifies clinical signs suggestive of arterial disease.

Venous examination of the lower limbs: if diabetic foot examination identified clinical signs suggestive of venous disease.

Foot care advice: including regular podiatry input and appropriate footwear.

Calculation of diabetic foot risk using assessment tool: based on the clinical findings of the diabetic foot examination.