What is included in the physical examination of diabetic foot ulcers?

Updated: Oct 15, 2020
  • Author: Tanzim Khan, DPM; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Carry out the following in foot examination [33] :

  • Inspect the static posture of the feet on the examination table, as well as when weight-bearing.
  • ​Assess for gross deformities and determine if they are reducible or rigid
  • Assess ankle range of motion using the Silfverskiöld test - If there is limited ankle dorsiflexion (cannot pass neutral) with the knee both flexed and extended, it is considered gastrocsoleal tightness; if there is increased dorsiflexion with the knee flexed, however limited with the knee in extension, it is considered gastrocnemius equinus 
  • Assess range of motion at the interphalangeal joints, metatarsophalangeal joints, midtarsal joints, and subtalar joints
  • Evaluate muscle power of dorsiflexors, plantar flexors, invertors, and evertors to identify any muscular imbalances
  • Examine the skin for dryness and fissures, as well as for discrete calluses; hemorrhagic calluses in particular are a sign of impending foot ulceration.

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