PODIATRIST NOTES TWO PITFALLS TO AVOID WHEN EVALUATING THE DIABETIC FOOT

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John M. Giurini, DPM, Chief of the Division of Podiatric Surgery at Beth Israel Deaconess Medical Center, Joslin Diabetes Center, Harvard Medical School notes two common pitfalls to avoid when evaluating the diabetic foot. The first is often overlooked, he says, "and that is the severity of peripheral vascular disease and the severity of foot infections in the diabetic patient." He emphasizes that "physicians who are inexperienced may look at a patient's foot and say, 'Well, it looks pink. It feels warm. Therefore, it must have good blood flow.' When in fact it may not."

 

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Dr. John Giurini

 

Such a patient may have critical limb ischemia, nonpalpable pulses, and an inability to heal. "I have seen a number of patients who have been treated for months at a time with no improvement, not because they're getting inadequate care, but because they have significant peripheral vascular disease that has not been recognized." Second, "diabetic patients are noted to be the great masqueraders," he says. "They can have a significant infection without having a significantly elevated white blood cell count or a significant temperature rise."

 

Source: mdmag.com [5/31/20]


Courtesy of Barry Block, editor of PM News



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