Comprehensive Foot Exam

Pt presents in Office for a for a comprehensive foot exam with [textarea name="variable_1" default="sample text"] 

 history of:
• previous leg/foot ulcer or lower limb amputation/surgery?
• prior angioplasty, stent, or leg bypass surgery?
• foot wound requiring more than 3 weeks to heal?
• smoking or nicotine use?
• diabetes? (If yes, what are the patient’s current control measures?)
Does the patient have:
• burning or tingling in legs or feet?
• leg or foot pain with activity or at rest?
• changes in skin color, or skin lesions?
• loss of lower extremity sensation?
Has the patient established regular podiatric care?

Dermatologic exam:
• Does the patient have discolored, ingrown, or elongated nails?
• Are there signs of fungal infection?
• Does the patient have discolored and/or hypertrophic skin lesions, calluses, or corns?
• Does the patient have open wounds or fissures?
• Does the patient have interdigital maceration?
Neurologic exam:
• Is the patient responsive to the Ipswich Touch Test?

Musculoskeletal exam:
• Does the patient have full range of motion of the joints?
• Does the patient have obvious deformities? If yes, for how long?
• Is the midfoot hot, red, or inflamed?

Vascular exam:
• Is the hair growth on the foot dorsum or lower limb decreased?
• Are the dorsalis pedis and posterior tibial pulses palpable?
• Is there a temperature difference between the calves and feet, or between the left
and right foot?

Education: Recommendations for daily foot care:
• Visually examine both feet, including soles and between toes. If the patient can't do this,
have a family member do it.
• Keep feet dry by regularly changing shoes and socks; dry feet after baths or exercise.
• Report any new lesions, discolorations, or swelling to a health care professional.
Education regarding shoes:
• Educate the patient on the risks of walking barefoot, even when indoors.
• R ecommend appropriate footwear and advise against shoes that are too small, tight, or rub
against a particular area of the foot.
• Suggest yearly replacement of shoes—more frequently if they exhibit high wear.
Overall health risk management:
• Recommend smoking cessation (if applicable).
• Recommend appropriate glycemic control.