Diabetic neuropathy physical examination

	Diabetic neuropathy Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Diabetic neuropathy from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Diabetic neuropathy physical examination On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Diabetic neuropathy physical examination All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Diabetic neuropathy physical examination
CDC on Diabetic neuropathy physical examination
Diabetic neuropathy physical examination in the news
Blogs on Diabetic neuropathy physical examination
Directions to Hospitals Treating Diabetic neuropathy
Risk calculators and risk factors for Diabetic neuropathy physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Please help WikiDoc by adding content here. It's easy! Click here to learn about editing.

Overview

Physical Examination

A study by the International Cooperative Group for Clinical Examination Research found that the monofilament and reflex testing were the most reproducible^[1]. This study also found that monofilament testing of four locations per foot was adequate.

A systematic review by the Rational Clinical Examination found that "Abnormal results on monofilament testing and vibratory perception (alone or in combination with the appearance of the feet, ulceration, and ankle reflexes) are the most helpful signs"^[2].

Images

(Images courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, California)

Diabetes induced neuropathy has lead to large, painless ulcer on bottom of foot. Patient has had toes removed several years earlier due to prior infection.

Severe diabetes induced neuropathy has resulted in Charcot foot deformity. This ultimately lead to large painless ulcer on bottom of foot.
Diabetes induced neuropathy that has lead to painless ulcer on bottom of foot.
Diabetes induced neuropathy led to development of the ulcer shown above. The Q-tip easily passes to the level of the underlying bone, clinical evidence of osteomyelitis. Incidentally, this is not painful to the patient as he is insensate.