Spectrum of foot pathology in diabetes: neuropathy, ischaemia, infection, ulceration, Charcot.
History taking
- • Onset, duration, progression, severity
- • Aggravating / relieving factors
- • Past history, drugs, allergies, comorbidities
- • Family & social history relevant to presentation
Examination
- • General: vitals, pallor, icterus, oedema, lymphadenopathy
- • Focused system examination
- • Look for red-flag findings
Red flags
- • Haemodynamic instability
- • Rapid deterioration
- • Severe pain or new neurological deficit
Differential diagnosis
- • See differentials section per chief complaint
Recommended investigations
- • Wound swab, X-ray (osteomyelitis), MRI if deep infection
- • ABI, vascular assessment
- • HbA1c
Diagnosis
- • Clinical diagnosis supported by targeted investigations
Initial treatment / management
- • Off-loading, debridement
- • Antibiotics per culture
- • Vascular / orthoplastic referral
Follow-up advice
- • Review in 2–4 weeks or earlier if worsening
- • Monitor response to therapy and adverse effects
Patient counselling
- • Daily foot inspection, properly fitted footwear, smoking cessation
Referral criteria
- • Refer if diagnostic uncertainty, complications, or failure of first-line therapy
References
- • Harrison's Principles of Internal Medicine, 21e
- • NICE / WHO guidelines (current edition)
Educational outpatient guide — verify against local guidelines before clinical use.
