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Foot Exam Instructions
Visual Foot Inspection
Objectives
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Quickly identify an obvious foot problem.
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Document foot inspection findings.
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Determine the need for a comprehensive foot exam.
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Schedule follow-up care and referrals.
Instructions
A physician, nurse, or other trained staff may complete this inspection.
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Inspect the foot between the toes and from toe to heel. Examine the skin for injury, calluses, blisters, fissure, ulcers, or any unusual condition.
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Look for thin, fragile, shiny, and hairless skin—all signs of decreased vascular supply.
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Feel the feet for excessive warmth and dryness.
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Remove any nail polish. Inspect nails for thickening, ingrown corners, length, and fungal infection.
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Inspect socks or hose for blood or other discharge.
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Examine footwear for torn linings, foreign objects, breathable materials, abnormal wear patterns, and proper fit.
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If any new foot abnormality is found, the patient should be scheduled immediately for a comprehensive foot examination.
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Document findings in the medical record.
Frequency of Inspection
Current clinical recommendations1 call for visual inspection of the feet:
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At every visit for people who have neuropathy.
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At least twice a year for people with one or more high risk* foot conditions to screen for the development of additional risk factors.
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At least annually, or more often if warranted, for low risk feet.*
In populations where the prevalence and incidence of diabetes foot problems are high, providers may determine that inspection of the feet at every visit — for both low and high risk patients — is warranted. To facilitate foot inspection and examination, consider adopting a policy such as “For all patients with diabetes, remove shoes and socks in preparation for examination.”
*Refer to chart for definitions of risk.
1 American Diabetes Association: Clinical Practice Recommendations 2000. Diabetes Care 2000:23(Suppl.1); S55-56.
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National Diabetes Education Program (NDEP) http://ndep.nih.gov
NIDDK, National Institutes of Health, Bethesda, MD
A Joint Initiative of the National Institutes of Health and the
Centers for Disease Control and Prevention |
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