Diabetic foot physical examination: Difference between revisions
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==Physical Examination== | ==Physical Examination== | ||
===Inspection=== | ===Appearance of the Patient=== | ||
* Dilated veins | *[[Patients]] with [[diabetic foot]] [[ulcer]] could appear ill developed [[ulcers]]. | ||
* Scar | ===Vital Signs=== | ||
* Shiny skin | *±[[Fever]] (Base on [[infection]] severity can present as high or low grade [[fever]]) | ||
* Hair distribution | *[[Hypothermia]] or [[hyperthermia]] may be present | ||
* Areas of | *[[Tachycardia]] | ||
*Low [[blood pressure]] could be seen in [[sepsis|septic]] [[patients]] | |||
===Skin=== | |||
* Ulcers | *[[Skin]] [[physical examination|examination]] of [[patients]] with [[diabetic foot]] is usually normal, except for the [[foot]] [[skin]]. | ||
* Brittle or broken nail | ===HEENT=== | ||
* Fungal infection | * HEENT [[physical examination|examination]] of [[patients]] with [[diabetic foot]] is usually normal. | ||
===Palpation=== | ===Neck=== | ||
* Temperature ( | *[[Neck]] [[physical examination|examination]] of [[patients]] with [[diabetic foot]] is usually normal. | ||
* Tenderness (squeeze calf muscle and achilles tendon for tenderness) | ===Lungs=== | ||
* | *[[Pulmonary]] [[physical examination|examination]] of [[patients]] with [[diabetic foot]] is usually normal. | ||
* Capillary filling time | ===Heart=== | ||
* Ulcers in pressure | *[[Circulatory system|Cardiovascular]] [[physical examination|examination]] of [[patients]] with [[diabetic foot]] is usually normal. | ||
===Abdomen=== | |||
*[[abdomen|Abdominal]] [[physical examination|examination]] of [[patients]] with [[diabetic foot]] is usually normal. | |||
===Back=== | |||
*[[human back|Back]] [[physical examination|examination]] of [[patients]] with [[diabetic foot]] is usually normal. | |||
===Genitourinary=== | |||
*Genitourinary [[physical examination|examination]] of [[patients]] with [[diabetic foot]] is usually normal. | |||
===Neuromuscular=== | |||
*[[Neuromuscular junction|Neuromuscular]] [[physical examination|examination]] of [[patients]] with [[diabetic foot]] is usually normal, except in their [[foot]]. [[physical examination|Examine]] their foot for the following: | |||
**Motor [[physical examination|examination]] | |||
***Tone | |||
***Power | |||
***[[Neurological examination|Reflexes]] | |||
**Sensory [[physical examination|examination]] | |||
***Vibration | |||
***[[Joint]] position sense | |||
===Extremities=== | |||
====Inspection==== | |||
*Peeling [[skin]], [[maceration]], [[fissure|fissuring]] between [[toe|toes]] | |||
*Dilated or [[varicose veins]] | |||
*[[Scar]] | |||
*Sinuses | |||
*Shiny [[skin]] | |||
*[[Hair]] distribution | |||
*Areas of [[Biological pigment|pigmentation]] or discoloration | |||
*[[Ulcers]] | |||
*Brittle or broken [[nail]] | |||
*[[fungi|Fungal]] [[infection]] | |||
*[[Foot]] deformities such as [[charcot joint|charcot foot]] and [[hammer toe]] | |||
====Palpation==== | |||
*Temperature (increased temperature could be due to [[deep vein thrombosis]] while decreased temperature could be an [[ischemia]] presentation) | |||
*[[Tenderness]] (squeeze [[Tibia|calf]] [[muscle]] and [[achilles tendon]] for [[tenderness]]) | |||
*[[pulse|Pulses]] such as [[Dorsalis pedis artery|dorsalis pedis]] | |||
*[[Capillary]] filling time | |||
*[[Ulcers]] in the areas under pressure such as base of the [[toe]] or the fifth [[metatarsus]] and posterior aspect of heel | |||
===Video: Physical Examination Diabetes=== | ===Video: Physical Examination Diabetes=== | ||
Revision as of 20:36, 14 March 2021
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Diabetic foot Microchapters |
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Treatment |
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Case Studies |
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Diabetic foot physical examination On the Web |
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American Roentgen Ray Society Images of Diabetic foot physical examination |
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Risk calculators and risk factors for Diabetic foot physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]
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Overview
Physical Examination
Appearance of the Patient
- Patients with diabetic foot ulcer could appear ill developed ulcers.
Vital Signs
- ±Fever (Base on infection severity can present as high or low grade fever)
- Hypothermia or hyperthermia may be present
- Tachycardia
- Low blood pressure could be seen in septic patients
Skin
- Skin examination of patients with diabetic foot is usually normal, except for the foot skin.
HEENT
- HEENT examination of patients with diabetic foot is usually normal.
Neck
- Neck examination of patients with diabetic foot is usually normal.
Lungs
- Pulmonary examination of patients with diabetic foot is usually normal.
Heart
- Cardiovascular examination of patients with diabetic foot is usually normal.
Abdomen
- Abdominal examination of patients with diabetic foot is usually normal.
Back
- Back examination of patients with diabetic foot is usually normal.
Genitourinary
- Genitourinary examination of patients with diabetic foot is usually normal.
Neuromuscular
- Neuromuscular examination of patients with diabetic foot is usually normal, except in their foot. Examine their foot for the following:
- Motor examination
- Tone
- Power
- Reflexes
- Sensory examination
- Vibration
- Joint position sense
- Motor examination
Extremities
Inspection
- Peeling skin, maceration, fissuring between toes
- Dilated or varicose veins
- Scar
- Sinuses
- Shiny skin
- Hair distribution
- Areas of pigmentation or discoloration
- Ulcers
- Brittle or broken nail
- Fungal infection
- Foot deformities such as charcot foot and hammer toe
Palpation
- Temperature (increased temperature could be due to deep vein thrombosis while decreased temperature could be an ischemia presentation)
- Tenderness (squeeze calf muscle and achilles tendon for tenderness)
- Pulses such as dorsalis pedis
- Capillary filling time
- Ulcers in the areas under pressure such as base of the toe or the fifth metatarsus and posterior aspect of heel
Video: Physical Examination Diabetes
{{#ev:youtube|715j6zRZHaA}}
Image: Diabetic Foot Ulcer
