Examine the lower or supper limbs of this diabetic patient.

Proceed as follows :

  1. Inspection :
    ★Necrobiosis lipoidica diabeticorum (central yellow scar with surrounding red margin, found over the shins due to atrophy of subcutaneous collagen)

    ★Ulceration and infection (boil, abscess,gangrene, carbuncle and cellulities) Look at the sole and between the toes.

    ★Diabetic dermopathy (small rounded plaques with raised border over the shins in a linear orientation). Look for any pigmentation scars (late diabetic dermopathy) 
    

    ★Injection mark on thaighs and fat atrophy or hypertrophy.

    ★Hair loss and skin atrophy (found in small vessel disease)
    IMG_20180725_205149.jpg

    ★Muscle wasting (due to neuropathy or diabetic amyotrophy or as a part of Generalized wasting)

    ★Examine both knee joint(swollen joints deformity indicates Charcot joints)

  2. Palpation :
    ★Temperature (may be cold and blue due to peripheral vascular diseases and associated skin atrophy or absent pulse)

    ★Pulsation(absent due to peripheral vascular disease or atherosclerosis)and bounding pulse (in neuropathy) 
    

    ★Pitting oedema.

3)Auscultate over femoral artery (for bruit)

4)Perform neurological examination of lower limbs.

★★★Next Coming..."" Examination of eye in diabetic persone"".

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