Examination of ulcers




How can the aetiology of an ulcer be deduced from the examination findings?




































































Arterial Venous Neuropathic Diabetic Malignant
Location Distal areas: heels, tips of toes, metatarsal heads, dorsal and plantar aspects of foot Gaiter area: medial and lateral malleoli and lower legs Pressure areas: heels, metatarsal heads, toe tips Variable Variable
Edge Punched out, deep Sloping, shallow Punched out, deep Variable Rolled, everted, irregular or pigmented
Base Bloodless, pale or necrotic Sloughy, pink or bleeding Pink or bleeding Sloughy, necrotic Indurated, hard
Sensation Painful Painful Insensate (stocking distribution) May be insensate Normal
Surroundings Cold limb, reduced capillary refill time Chronic venous changes Foot deformity / Charcot’s joint Cellulitis Satellite lesion, lymphadenopathy
Pulses Absent Present (unless mixed arteriovenous), foot well perfused Variable Variable Present
ABPI Low Normal Normal High Normal

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Feb 18, 2017 | Posted by in GENERAL SURGERY | Comments Off on Examination of ulcers

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