Diabetic foot examination

Question 1

What are the steps of a diabetic foot examination?

Answer 1

Inspection
Palpation
Vascular examination
Neurological examination

Question 2

What should you inspect?

Answer 2

Gait
Footwear
Skin
Feet

Question 3

What should you look for in the skin?

Answer 3

Trophic changes - hair loss, pallor, decreased sweating, dry cracked skin
Rubor at pressure points
Skin ulceration
Diabetic dermopathy
Infection - cellulitis, gangrene
Webspaces - cracked, infected, ulcers, maceration
Toe nails - dystrophic, in-growing, paronychia, onychomycosis

Question 4

What do you look for in the feet?

Answer 4

Deformities
Intrinsic muscle wasting - clawed, hammer toes
Pes planus
Pes cavus

Question 5

What do you palpate?

Answer 5

Bones and joints of ankle and foot for swelling and tenderness

Question 6

What do you do in the vascular examination?

Answer 6

Temperature
Pulses - femoral, popliteal, posterior tibial, dorsalis pedis
CRT

Question 7

What do you do in the neurological examination?

Answer 7

Ankle jerk reflex

Sensation - light touch, pressure, pin prick, temperature, proprioception, vibration