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Table 3—

Key components of the diabetic foot exam

Inspection 
    Dermatologic 
  • skin status: color, thickness, dryness, cracking

  • sweating

  • infection: check between toes for fungal infection

  • ulceration

  • calluses/blistering: hemorrhage into callus?

 
    Musculoskeletal 
  • deformity, e.g., claw toes, prominent metatarsal heads, Charcot joint (Fig. 1)

  • muscle wasting (guttering between metatarsals)

 
Neurological assessment 
    10-g monofilament + 1 of the following 4 
  • vibration using 128-Hz tuning fork

  • pinprick sensation

  • ankle reflexes

  • VPT

 
Vascular assessment 
  • foot pulses

  • ABI, if indicated

 
Inspection 
    Dermatologic 
  • skin status: color, thickness, dryness, cracking

  • sweating

  • infection: check between toes for fungal infection

  • ulceration

  • calluses/blistering: hemorrhage into callus?

 
    Musculoskeletal 
  • deformity, e.g., claw toes, prominent metatarsal heads, Charcot joint (Fig. 1)

  • muscle wasting (guttering between metatarsals)

 
Neurological assessment 
    10-g monofilament + 1 of the following 4 
  • vibration using 128-Hz tuning fork

  • pinprick sensation

  • ankle reflexes

  • VPT

 
Vascular assessment 
  • foot pulses

  • ABI, if indicated

 
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