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Table 13. Components of a Comprehensive Foot Evaluation
for Patients With PAD
History
Previous foot ulcer(s) or CLTI, amputation, Charcot deformity, calluses
Current symptoms of PAD or CLTI: claudication or other leg fatigue with walking, rest
pain, foot ulcers
Lower extremity revascularization (endovascular or surgical procedures)
Cigarette or other tobacco use (current, past)
Diabetes
Retinopathy or visual impairment
CKD
Symptoms of neuropathy (ie, pain, burning, numbness in feet)
History of other CVD (eg, CAD, heart failure, cerebrovascular disease)
Physical examination
Evaluate skin integrity, including presence of any ulcers, calluses, or corns. Visual
inspection includes the whole foot and in between all toes
Examine for foot deformity (eg, bunion, hammertoe or claw toe, abnormal foot arch,
Charcot deformity)
Perform neurological assessment: 10-g monofilament testing with at least 1 other
measurement: pinprick, temperature, or vibration
Evaluate (palpate) pulses in the legs and feet
Other assessments
Footwear: Is it ill-fitting, inadequate, or is there lack of footwear?
Does patient have poor foot hygiene (eg, improperly cut toenails, unwashed feet,
superficial fungal infection, or unclean socks)?
Does the patient have physical limitations that may hinder foot self-care (eg, visual
impairment, obesity, inability to reach feet)?
Does the patient know the components of and perform self-foot care?