Diabetic Foot Exams Flashcards
What equipment do you need?
Monofilament Tuning fork (128Hz) Tendon hammer
What are the principles of the exam?
Inspection
Palpation
Sensation
Gait
What do you look for in inspection?
Skin changes
Ulcers
Other abnormalities
What skin changes do you look for?
Pallor Hair loss Shiny skin Erythema - sign of cellulitis Calluses - abnormal gait or inappropriate footwear
What ulcers appear in diabetics?
Arterial
Neuropathic
What are the features of an arterial ulcer?
Very painful
Deep punched out appearance
End of digits or lateral ankle
What are the features of neuropathic ulcers?
Punched out appearance
Pressure sites
Peripheral neuropathy
What other abnormalities can be seen?
Venous guttering
Charcot arthropathy
What is venous guttering?
Appearance of veins with very little blood in them
What is charcot arthropathy?
Progressive degeneration of a weight-bearing joint
- bony destruction
- bone resorption
- deformity
What are the clinical signs of charcot arthropathy?
Joint deformity
Swelling
Erythema
What do you palpate?
Pulses
- dorsalis pedis
- posterior tibial
How do you test sensation?
Use monofilament
- provide example against arm/sternum
- Apply monofilament to
- pulp of hallux
- pulp of 3rd digit
- mtpj 1, 3, 5 - Use sufficient force to slightly bend monofilament
What are you looking for in patients gait?
Symmetry
Unsteadiness
Able to turn
What else do you need to examine?
Patients footwear
