A 54-year-old smoker with type 2 diabetes of 7 years duration had a minor abrasion to the lateral aspect of the left fifth toe. The patient was known to have hypertension, nephropathy and retinopathy, and he was overweight. His glycaemic control was good following recent addition of insulin to his oral medication. The superficial ulcer did not bother the patient, and it was initially followed up in his local healthcare centre. Two months later, the patient was referred to a community hospital because of infection and suspicion of osteomyelitis. He now had an infected ulcer lateral to the head of the fifth metatarsal, with a discharge. Plain X-ray films showed suspected osteomyelitis. Dorsalis pedis and posterior tibial pulses were reported to be present. The C-reactive protein (CRP) level was 31 mg/L, leucocytes 14.8 × 109/L, and blood glucose 12 mmol/L.
- 3.Levin ME, O’Neal LW. The diabetic foot. St Louis: Mosby; 1983.Google Scholar
- 8.International Working Group on the Diabetic Foot. International consensus on the diabetic foot. Netherlands: International Working Group on the Diabetic Foot; 1999.Google Scholar
- 14.Biancari F, Kantonen I, Albäck A, Ihlberg L, Lehtola A, Lepäntalo M. Popliteo-to-distal bypass grafts for leg ischaemia. J Cardiovasc Surg. 2000;41:281–6.Google Scholar