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Foot Complications

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Abstract

Patient C was a 50-year-old diabetic male truck driver. He presented to the emergency department with a red, hot, painful, swollen right foot and lower leg. There were no open lesions with unilateral edema and diffuse erythema. A venous duplex ultrasound was negative for deep venous thrombosis. Laboratory data showed no leukocytosis. The patient was admitted, placed on broad spectrum I.V. antibiotics, and discharged three days later. He returned to the emergency department 3 days after discharge with the same complaint of persistent redness and swelling. A second venous ultrasound was negative for thrombosis, and he was discharged home with a new oral antibiotic and a referral to the podiatry clinic. After a 2 week delay in obtaining an appointment, the patient noted his right foot had changed shape and was flatter in the arch than the contralateral foot. The deformity progressed to ulceration requiring surgical intervention. This unfortunate outcome in which the correct diagnosis of acute Charcot neuroarthropathy was missed resulted in considerable patient morbidity and increased healthcare utilization.

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Authors and Affiliations

  1. School of Podiatric Medicine, Department of Surgery, UTRGV School of Podiatric Medicine, Edinburgh, TX, USA

    Lawrence B. Harkless

  2. Western University of Health Sciences College of Podiatric Medicine, Chino Valley Medical Center, Chino, CA, USA

    Jarrod Shapiro

  3. Multidisciplinary Diabetes Center Mexico, Mexico City, Mexico

    Joel Rodriguez-Saldana

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  1. Lawrence B. Harkless
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  2. Jarrod Shapiro
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  3. Joel Rodriguez-Saldana
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  1. Mexico City, Mexico

    Joel Rodriguez-Saldana

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Harkless, L.B., Shapiro, J., Rodriguez-Saldana, J. (2023). Foot Complications. In: Rodriguez-Saldana, J. (eds) The Diabetes Textbook. Springer, Cham. https://doi.org/10.1007/978-3-031-25519-9_62

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  • DOI: https://doi.org/10.1007/978-3-031-25519-9_62

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