Keys To The Diagnostic Workup For Patients With Diabetic Foot Infections
While infection is a clinical diagnosis, true severity may be masked in patients with diabetes. The workup of a diabetic foot infection presented here outlines how to perform a thorough history, focusing on pertinent questions to ask the patient, a thorough focused lower extremity examination, what laboratory tests to order and what imaging studies to consider to properly assess the severity of the infection.
Several studies have shown that one cannot determine the severity of a diabetic foot infection based on a single history, physical exam, laboratory or imaging finding.1-3,34 Rather, a combination of all of these findings should dictate the proper treatment pathway to follow — such as outpatient versus inpatient management or medical versus surgical therapy — for appropriate treatment.
Dr. Schade is the Chief of the Limb Preservation Service and Director of the Complex Lower Extremity Surgery and Research Fellowship at Madigan Healthcare System in Tacoma, Wash. She is an Associate of the American College of Foot and Ankle Surgeons.
Dr. Higa is the Fellow in the Complex Lower Extremity Surgery and Research Fellowship at Madigan Healthcare System in Tacoma, Wash. He is an Associate of the American College of Foot and Ankle Surgeons.