×
MedSchool: Ace Your OSCEsThe Medical Company
 
 
 
 
 
GET - On the App Store
View
Diabetic Exam
 
 

Lower Limb Ulceration

 
 
 
Bookmark

Overview

  • Ulcers, or non-healing open wounds, may occur in the lower limb in the context of arterial disease, venous disease or peripheral neuropathy.

Arterial Ulcers

  • The presence of white, painful ulcers suggests a partial or complete arterial occlusion.
    • Look For

    • Deep, painful white ulcers with blanched surrounding tissue, affecting the toes, heels and bony prominences. These ulcers may become black with necrosis.
    • Causes of Arterial Ulcers

    • Atherosclerosis
    • Diabetes
    • Thromboangiitis
    • Vasculitis

Venous Ulcers

  • Red, painless ulcers are suggestive of venous insufficiency.
    • Look For

    • Superficial painless red ulcers with moderate exudate, most commonly over the gaiter area (from mid-calf to 1cm below the malleoli)
    • Causes of Venous Ulcers

    • Venous hypertension due to incompetent valves
    • Venous outflow obstruction
    • Calf-muscle pump failure - obesity, immobility

Neuropathic Ulcers

  • Neuropathic ulcers occur due any cause of sensory loss to the foot, resulting in greater likelihood of damage and unawareness of injury.
    • Look For

    • Deep ulcers surrounded by callus, most commonly on weight bearing areas such as the sole of the foot. Associated with diminished sensation of the foot and normal pedal pulses.
 
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Want more info like this?
  • Your electronic clinical medicine handbook
  • Guides to help pass your exams
  • Tools every medical student needs
  • Quick diagrams to have the answers, fast
  • Quizzes to test your knowledge
Sign Up Now