Diabetic foot history and symptoms: Difference between revisions
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*Filament nerve conduction studies | *Filament nerve conduction studies | ||
*Quantitative sensory testing and autonomic testing | *Quantitative sensory testing and autonomic testing | ||
Sensory neuropathy causes: | |||
*Impaired [[vibration]] perception and position sense | |||
*Depressed tendon reflexes | |||
*Dull, crushing or cramp-like pain in the bones of the feet | |||
*Sensory [[ataxia]] | |||
*Shortening of the [[achilles tendon]] | |||
*Abnormal thresholds for warm thermal perception | |||
*Decreased neurovascular function | |||
Autonomic neuropathy is the increased or decreased blood flow to the foot (hot foot) with an increased risk of [[charcot neuroarthropathy]], decreased sweating, dry skin, impaired vasomotion and blood flow. These lead to cold feet which ultimately result into the loss of skin integrity, providing a vulnerable site for infection <ref name="pmid22529027">{{cite journal| author=Alexiadou K, Doupis J| title=Management of diabetic foot ulcers. | journal=Diabetes Ther | year= 2012 | volume= 3 | issue= 1 | pages= 4 | pmid=22529027 | doi=10.1007/s13300-012-0004-9 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22529027 }} </ref>. | |||
==References== | ==References== | ||
Revision as of 20:54, 30 January 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]
Overview
History
Symptoms
Dermatologic Assessment
- Visual inspection of the skin: peeling skin, maceration, fissuring between toes
- Skin temperature: Should be warm at the tibia cold at distal toe.
- Look for deformities, charcot foot, hammer toe, and heels.
Neuropathy Assessment
Symptoms include burning and pins and needles at early stages of the condition.
Using the neuropathy symptoms score (NSS)[1] and neuropathy disability score (NDS),[2] almost half of the patients with diabetes have some level of neuropathy prior to diagnosis.
The physician should assess;
- Muscle strength and tone
- Temperature
- Sensation
- Light touch
- Filament nerve conduction studies
- Quantitative sensory testing and autonomic testing
Sensory neuropathy causes:
- Impaired vibration perception and position sense
- Depressed tendon reflexes
- Dull, crushing or cramp-like pain in the bones of the feet
- Sensory ataxia
- Shortening of the achilles tendon
- Abnormal thresholds for warm thermal perception
- Decreased neurovascular function
Autonomic neuropathy is the increased or decreased blood flow to the foot (hot foot) with an increased risk of charcot neuroarthropathy, decreased sweating, dry skin, impaired vasomotion and blood flow. These lead to cold feet which ultimately result into the loss of skin integrity, providing a vulnerable site for infection [3].
References
- ↑ Meijer JW, Smit AJ, Sonderen EV, Groothoff JW, Eisma WH, Links TP (2002). "Symptom scoring systems to diagnose distal polyneuropathy in diabetes: the Diabetic Neuropathy Symptom score". Diabet Med. 19 (11): 962–5. PMID 12421436.
- ↑ Daousi C, MacFarlane IA, Woodward A, Nurmikko TJ, Bundred PE, Benbow SJ (2004). "Chronic painful peripheral neuropathy in an urban community: a controlled comparison of people with and without diabetes". Diabet Med. 21 (9): 976–82. doi:10.1111/j.1464-5491.2004.01271.x. PMID 15317601.
- ↑ Alexiadou K, Doupis J (2012). "Management of diabetic foot ulcers". Diabetes Ther. 3 (1): 4. doi:10.1007/s13300-012-0004-9. PMID 22529027.