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On inspection the clinician looks for signs of: trauma; previous surgery ()muscle wasting/muscle asymmetry; edema (swelling) erythema (redness); ulcers – arterial ulcers tend to be on the borders / sides of the foot, neuropathic ulcers on the plantar surface of the foot, venous ulcers tend on be on the medial aspect of the leg superior to the medial malleolus.
Diabetic foot infection is any infection of the foot in a diabetic person. [2] The most frequent cause of hospitalization for diabetic patients is due to foot infections. [ 3 ] Symptoms may include pus from a wound, redness, swelling, pain, warmth, tachycardia , or tachypnea. [ 4 ]
Diabetic foot ulcer is a breakdown of the skin and sometimes deeper tissues of the foot that leads to sore formation. It is thought to occur due to abnormal pressure or mechanical stress chronically applied to the foot, usually with concomitant predisposing conditions such as peripheral sensory neuropathy, peripheral motor neuropathy, autonomic neuropathy or peripheral arterial disease. [1]
Swelling, temperature and color changes in the feet, and calluses, are all telltale signs an ulcer may be around the corner and warrant a trip to a foot and ankle surgeon. 2.
Diabetic foot conditions can be acute or chronic complications of diabetes. [1] Presence of several characteristic diabetic foot pathologies such as infection, diabetic foot ulcer and neuropathic osteoarthropathy is called diabetic foot syndrome. The resulting bone deformity is known as Charcot foot.
Chronic ulcer symptoms usually include increasing pain, friable granulation tissue, foul odour, and wound breakdown instead of healing. [3] Symptoms tend to worsen once the wound has become infected. Venous skin ulcers that may appear on the lower leg, above the calf or on the lower ankle usually cause achy and swollen legs.
The skin surrounding a venous ulcer may be edematous (swollen) and there may be evidence of varicose veins; the skin surrounding an arterial ulcer may be pale, cold, shiny and hairless. Both venous and arterial ulcers may be painful, however arterial ulcers tend to be more painful, especially with elevation of the leg, for example when in bed.
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