Diabetic foot physical examination
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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]
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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
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Image: Diabetic Foot Ulcer
![Diabetic foot ulcer](/images/d/d0/Diabetic_foot_ulcer.jpg)