The human lower limbs are richly supplied with nerves and blood vessels. Their integrity may be affected by trauma or chronic illnesses such as diabetes and arthritis.
DM eats at the nerves and vessels silently and expertly. Screening for vascular and nerve damage is essential because the damage is often irreversible and with far-reaching effects such as amputation. The goal is to nip this in the bud.
Who should have vascular and neurological testing?
Typically, people with DM, vascular disease, poor blood flow, the elderly, smokers and those with symptoms such as numbness, coldness, cramping, and slow healing are advised to perform these tests.
Some form of testing should be done at every opportunity to see a podiatrist. These tests require skills and specialised instruments or devices. The vascular and nervous components are usually tested separately.
Podiatrists would usually begin with a general visual assessment to pick up signs of impending or established damage like shiny overlying skin, paleness, or hair loss.
Typically, a question and answer session would usually come before testing. This will be useful in making a diagnosis and for focused assessment.
Your podiatrist will look at, feel and move the lower limbs as part of the assessment.
Neurological assessment involves testing a range of sensations to ensure intactness. This would involve testing with a monofilament device, a tendon hammer for reflexes, and a tuning fork for the vibration sense.
Other sensations such as pain, pressure, light touch and joint position sense are tested [1].
Derangements may now prompt further testing and intervention.
Vascular assessment
Vascular testing checks the lower limb blood circulation. Vascular assessment is usually three-pronged.
It begins with looking for worrisome physical signs. Then, the pulses of the lower limb are felt. The coldness of the extremities and tenderness may be detected by touch.
The podiatrist then goes ahead to measure the ankle-brachial index (ABI). The ABI is the standard used to gauge circulation in the foot.
A Doppler device may be used to assess blood flow which will detect any areas of vascular narrowing [2].
Only well-perfused tissues are healthy. Poor blood flow slows wound healing and predisposes to infections and gangrene. This may ultimately lead to serious foot disorders or worse still, amputation.
Amputation can have devastating, physical, psychological and occupational effects. Wouldn’t it be better to avoid it in the first place?
Looking for top-notch disease foot care in the Gold Coast? Check out The Foot Stop. See your podiatrist today!
REFERENCES
- Neurovascular Foot Assessment. AC Podiatry. https://acpodiatry.com.au/service/neurovascular-foot-assessment/. Accessed 22-09-2020.
- How To Perform A Thorough Vascular Exam. Daniel Halloran, Peter Blume, and Michael Palladino. Podiatry Today. https://www.podiatrytoday.com/article/7074. Accessed 22-09-2020.
- The Foot Stop. https://thefootstop.com.au/. Accessed 22-09-2020.
