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
Investigations to consider
- microbiological culture
- renal function
- ankle/toe pressures
- angiography
- MRI foot
Treatment algorithm
Contributors
Authors
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 is a consultant for, and owns stocks in, Nangio TX. He is a member of the scientific advisory committees for Cesca, AnGes, and AstraZeneca. He is the Co-National Principal Investigator for the Voyager trial of Rivaroxaban in peripheral arterial disease patients undergoing intervention; funding for this institutional research grant goes directly to the Baylor College of Medicine.
Professor of Surgery
Director of Southwestern Academic Limb Salvage Alliance (SALSA)
Department of Surgery
Keck School of Medicine of University of Southern California
Los Angeles
CA
Disclosures
DGA declares that he has no competing interests.
Peer reviewers
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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