Diabetic Foot (Subscribe)  

The goal of this activity is to describe the diagnosis and treatment of Charcot's arthropathy of the foot and ankle.
John M. Embil, MD, FRCPC; Elly Trepman, MD Nat Rev Endocrinol CME. 2009;5(10):577-581.

American College of Foot and Ankle Surgeons (Podiatrists) Clinical Practice Guidelines: Diabetic Foot Disorders

Diabetic foot ulceration is a medical emergency and a major risk factor for subsequent extremity amputation. The incidence of extremity amputation for persons with diabetes in Canada is 4 per thousand per year.l The prevention and treatment of lower extremity ulceration has been strongly correlated with reduced amputation rates, thus...

Antimicrobial therapy for diabetic foot infections A practical approach Kevin W. Shea, MD VOL 106 / NO 1 / JULY 1999 / POSTGRADUATE MEDICINE CME learning objectives To identify factors that influence antibiotic selection in the treatment of diabetic foot infections To understand the microbiology of the infected diabetic foot To establish an effective...

From Applied Radiology Radiological Case of the Month Calcaneal Bone Osteomyelitis Posted 08/04/2004 Walter Silbert, MD; Maroun Karam, MD Case Summary A 51-year-old white man with a medical history significant for Type I diabetes mellitus and peripheral vascular disease necessitating multiple prior distal amputations presented with increasing right foot pain. He...

Radiology case 468-821 Clinical presentation: Middle aged insulin dependent diabetic with right ankle swelling and deformity. There is marked soft tissue swelling with fragmentation of the bones, joint destruction, but no reduction in bone density.

Conservative Management of Diabetic Foot Ulcers Complicated by Osteomyelitis from Wounds 2002 NG Yadlapalli, MD, Anand Vaishnav, MD, and Peter Sheehan, MD Abstract Osteomyelitis of the diabetic foot remains a difficult clinical infection, often resulting in disability and amputation. Standard management consists of thorough removal of all infected bone in conjunction with antimicrobial...

Diabetic foot disease usually sends an orthopaedic surgeon running. The usual response to a consult is "Call me when they need a below-knee amputation" as the surgeon disappears back to a busy and safe practice of joint replacements, arthroscopy and trauma. Diabetic feet are messy and infected, and the patients...

Diabetics develop a number of problems with their feet
Infections
Stiff deformities
Peripheral neuropathy
Peripheral vascular disease
Ulceration
Charcot neuropathic arthropathy
The causes of these are linked together.

Diabetic foot ulcers (DFUs) precede 85% of nontraumatic lower extremity amputations (LEAs). Approximately 3-4% of individuals with diabetes currently have foot ulcers or deep infections. Among persons with diabetes, 15% develop foot ulcers during their lifetime. Their risk of LEA increases by a factor of 8 once an ulcer develops....

Diabetes is a systemic disease that affects the vascular, nervous, integumentary and immune systems.
Epidemiology At any one time, 3-4% of patients with DM have a foot ulcer. 15% develop a foot ulcer over their lifetime.
When a foot ulcer develops the chance of going on to amputation increases 8 fold.

Sections on Diabetic Amputations & Diabetic Foot Pathology

Dialysis Linked to Foot Ulceration in Diabetic Patients In a cross-sectional study, dialysis treatment was independently associated with foot ulceration. Therefore, guidelines should highlight dialysis as an important risk factor for foot ulceration. Clinical Review, June 2010
June 1, 2010 — Dialysis treatment is independently associated with foot ulceration in patients with diabetes...

Selecting appropriate empiric antimicrobial therapy for diabetic foot infections requires knowing the likely etiologic agents, and assessing the seriousness of the infection. Initial therapy is usually empiric, while definitive therapy is based on the results of culture and sensitivity tests, as well as the clinical response to empiric therapy.
Benjamin A....

Diabetes is a multi-system condition leading to multiple end organ complications. Peripheral neuropathy is the key factor leading to the lower extremity complications of diabetes. These lower extremity complications include loss of protective sensation which leads to ulcerations, Charcot changes and there may also be associated neuropathic pain.
Brian P. Scharfstein,...