Key components of the diabetic foot examination

Inspection

Dermatologic

Skin status – color, thickness, dryness, cracking
Sweating
Infection – check between toes for fungal infection
Ulceration
Calluses/blistering – hemorrhage into callus?

Musculoskeletal

Deformity (eg, claw toes, prominent metatarsal heads, Charcot joint)
Muscle wasting (guttering between metatarsals)

Neurologic assessment

10 g monofilament + 1 of the following 4

Vibration using 128 Hz tuning fork
Pinprick sensation
Ankle reflexes
Vibration-perception threshold

Vascular assessment

Foot pulses
ABI, if indicated

ABI: ankle brachial index.

Reprinted with permission from: Boulton AJM, Armstrong DG, Albert ST, et al. Comprehensive Foot Examination and Risk Assessment: A report of the Task Force of the Foot Care Interest Group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists. Diabetes Care 2008; 31:1679. Copyright © 2008 American Diabetes Association.

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Key components of the diabetic foot examination