Last reviewed: November 2017
Last updated: January  2017

Summary

Definition

History and exam

Key diagnostic factors

  • history of diabetes mellitus
  • foot ulcer
  • foot pain
  • fever or chills

Other diagnostic factors

  • malaise
  • anorexia
  • foot erythema
  • edema of foot, ankle, or calf
  • absent pedal pulses
  • fluctuance

Risk factors

  • sensory neuropathy
  • previous history of foot ulcer
  • previous history of partial foot (toe) amputation
  • Charcot midfoot deformity
  • chronic kidney disease
  • structural forefoot deformities
  • limited ankle joint mobility (ankle equinus)
  • peripheral artery disease
  • visual impairment
  • poor glucose control

Diagnostic investigations

1st investigations to order

  • CBC
  • blood glucose level
  • x-ray foot
Full details

Investigations to consider

  • renal function
  • ankle/toe pressures
  • angiography
  • MRI foot
Full details

Emerging tests

  • CT angiography
  • ESR
  • CRP
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Assistant Professor

Division of Vascular Surgery and Endovascular Therapy

Michael E. DeBakey Department of Surgery

Baylor College of Medicine

Houston

TX

Disclosures

NRB declares that he has no competing interests.

Professor and Chief

Division of Vascular Surgery and Endovascular Therapy

Michael E. DeBakey Department of Surgery

Baylor College of Medicine

Houston

TX

Disclosures

JLM declares that he has no competing interests.

Professor of Surgery

Director of Southern Arizona Limb Salvage Alliance (SALSA)

Department of Surgery

University of Arizona College of Medicine

Tucson

AZ

Disclosures

DGA declares that he has no competing interests.

Peer reviewers VIEW ALL

Chief, Division of Foot and Ankle Surgery

Director, Foot and Ankle Fellowship Program

Department of Orthopedic Surgery

The University of Texas

Galveston

TX

Disclosures

VP declares that he has no competing interests.

Reader and Honorary Consultant Vascular Surgeon

St George's Vascular Institute

London

UK

Disclosures

RH declares that he has no competing interests.

Executive Medical Director/Podiatrist

Amputation Prevention Center

Los Angeles

CA

Disclosures

LR declares that he has no competing interests.

Highly Specialist Podiatrist

Lancashire Care Foundation NHS Trust

Preston

UK

Disclosures

JS declares that she has no competing interests.

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