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Diabetic Exam
 
 
 
 
Diabetic Exam
Poor diabetic control may manifest in many different ways, with macrovascular and microvascular complications. The diabetic examination is useful for diagnosing these complications, particularly when it comes to the vascular and neurologic examination of the lower limb.
 

Pedal Oedema

 
 

Overview

    • Look For

    • Swelling of the lower limb due to fluid accumulation.

Pitting Oedema

    • How to Elicit

    • Apply pressure to the anterior aspect of the tibia for fifteen seconds and then release.
    • Look For

    • Persistence of the depressed area after pressure is removed.
    • Causes of Pitting Oedema

    • Fluid overload - excessive IV fluids, renal failure, heart failure
    • Right ventricular failure
    • Venous pathology - thrombosis / insufficiency
    • Dependency (the effect of gravity)
    • Hypoalbuminaemia - malnutrition, malabsorption, nephrotic syndrome, liver (synthetic) failure

Non-Pitting Oedema

    • Look For

    • Oedema to the lower limbs that does not pit.
    • Causes of Non-Pitting Oedema

    • Impaired lymphatic drainage
    • Pretibial myxoedema (hypothyroidism)
Last updated on November 28th, 2019
 
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