Archive:Diabetic Foot Exam: Difference between revisions

Revision as of 07:42, 17 May 2007

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+==Inspection==
+===General==
+*gait, shoes, heels
+===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
+*toe nails: dystrophic, in grown, [paronychia], [Onychomycosis]
+==Palpation==
+===Pulses===
+*femoral
+*popliteal
+*posterior tibial
+*dorsalis pedis
+===Temperature===
+*use back of hand, compare shin to feet, bilaterally
+===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)
+*[Pes planus], [Pes cavus]
+*'''Charcot joints''' (medial and laterial deviation at subtalar joint)
+===Reflexes===
+*DTR: ↓ ankle jerk
 {{OSCE2}}
-[Category:Medicine][Category:OSCE]
+[[Category:Medicine]][[Category:OSCE]]