We sometimes see diabetic patients in the ED for a worsening foot ulcer. Sometimes it’s the chief complaint. Other times, however, you just notice it on physical exam. So, be sure you examine the feet of your diabetic patients. Occasionally, you’ll be surprised by what you find.
Several questions come up with diabetic foot ulcers:
- Is it a true diabetic foot ulcer, or is it an arterial or venous insufficiency ulcer?
- Is there underlying osteomyelitis?
- How can I best diagnostically work this foot ulcer up for osteomyelitis?
- What is the Wagner grade of this ulcer? (I think it’d be Grade 2.)