Diabetic Foot Syndrome

In this section, Prof G Sivakumar lists down the clinical signs of Diabetic Foot syndrome.

Diabetic Foot Syndrome

Identifying  long-term complications of diabetes and preventing ulceration in the foot.

Neuropathy is common in 30 to 40 % of patients with diabetic mellitus. 20% of them develop foot ulcers.

These are clinical and radiological signs that foretell the ulceration.

These are referred as GRADE – O lesions.

  • “Intrinsic minus” deformity due to wasting of small muscles.


  • Neuropathic joint  is common and is called “CHARCOT”joint.
  • “Monckeberg’s sclerosis” of the Tibial arteries is due to calcification of the Tunica media.


  • Prominent leg veins in recumbent posture, called JD Ward sign. This is due to increased venous flow due to a-v shunting of blood at the capillary level due to neuropathy.
  • Hyper extension at First metatarso – phalyngeal joint. This deformity is common in the development of plantar ulcers.


  • Collapse of foot arches.
  • Fractures and dislocations.
  • Osteopaenia.
  • Unaware of foreign bodies.
  • Pedal edema.
  • Absent pedal arterial pulses.
  • Plantar sites of peaking pressure points & callosities.
  • Bunions & bursae.
  • Reduced Vibration sensation.
  • Gas shadows in skiagram, signs of impending ulceration.
  • Hallux valgus & rigidus.

Ulceration in the foot in diabetics is predictable and preventable”