Obtain ABI on all patients with: nonpalpable DP/PT, claudication symptoms, ischemic<unk>  pain
Consider vascular consult if abnormal:
ABI <0.4 (severe obstruction)
ABI 0.4-0.69 (mod obstruction)
Consider vascular consult if abnormal:
ABI <0.4 (severe obstruction)
ABI 0.4-0.69 (mod obstruction)
ABI <0.4 (severe obstruction)
ABI 0.4-0.69 (mod obstruction)
Chem 10, CBC, Coags, A1c, consider ESR/CRP (useful for monitoring response to treatment)
ESR >40 increased chance of OM 12 fold, an ESR >70 makes diagnosis nearly certain.
X-rays to detect soft tissue gas, foreign body, OM, or structural<unk>  deformities
OM: x-ray changes occur late in disease, negative xrays do not exclude
MRI to eval for OM (not usually done in ED)
OM: x-ray changes occur late in disease, negative xrays do not exclude
Determine presence/extent of<unk>  and likelihood of OM/fasciitis
Consider Charcot arthropathy<unk>  neuropathic osteoarthropathy)
commonly missed diagnosis
requires different management (total contact cast, NWB)
commonly missed diagnosis
requires different management (total contact cast, NWB)
Factors that increase likelihood of osteomyelitis:
Visible bone or probe to bone
Ulcer >2cm in size
ESR >70
Ulcer duration >2 weeks
Visible bone or probe to bone
Ulcer >2cm in size
ESR >70
Ulcer duration >2 weeks
Diabetic foot infection
Cellulitis
Venous gangrene
Gangrene
Wet gangrene
Dry gangrene
Necrotizing cellulitis
Trench foot