Archive:Diabetic Foot Exam: Difference between revisions

Latest revision as of 05:48, 7 June 2009

@@ Line 1: / Line 1: @@
+==Inspection==
+===General===
+*gait, shoes, heels
+{{ntnes}}
+===Skin===
+*vascular insufficiency - hairlessness, pallor
+*rubor at pressure points
+*skin breakdown (portal for infections)
+*'''diabetic dermopathy''' (brown macules) over shins
+*infection: cellulitis (erythema, swelling), gangrene
+===Other===
+*webspaces: cracked, infected, ulcers, maceration
+*toe nails: dystrophic, in-grown, [[wikipedia:paronychia|paronychia]], [[wikipedia:Onychomycosis|Onychomycosis]]
+==Palpation==
+===Pulses===
+*femoral
+*popliteal
+*posterior tibial
+*dorsalis pedis
+===Temperature===
+*use back of hand, compare shin to feet, bilaterally
+*temperature should decrease slightly as you get toward the toes
+===Other===
+*Capillary refill
+==Ascultation==
+*Bruits: femoral, popliteal
+==Neurological==
+===Sensory===
+*↓ vibration (1st modality to loose, 128 Hz)
+*↓ light touch (microfilament)
+*↓ pin prick
+*↓ proprioception
+*↓ temperature
+*(loss in glove and stocking distribution)
+===Autonomic===
+*↓ sweating
+*dry cracked skin
+===Motor===
+*intrinsic muscle wasting (clawed, hammer toes)
+*[[wikipedia:Pes planus|Pes planus]], [[wikipedia:Pes cavus|Pes cavus]]
+*'''Charcot joints''' (medial and laterial deviation at subtalar joint)
+===Reflexes===
+*DTR: ↓ ankle jerk
+==Other OSCE modules==
 {{OSCE2}}
-[Category:Medicine][Category:OSCE]
+[[Category:Clinical Skills]][[Category:OSCE]][[Category: Endocrinology]]