LEG ULCERATION

Ask the Following Questions:

1. Are the peripheral pulses diminished or absent? Presence of poor peripheral pulses suggests arteriosclerosis, diabetes mellitus, Buerger's disease, and femoral artery thrombosis.
2. Are there abnormalities on the neurologic examination? Neurologic disorders associated with leg ulceration include tabes dorsalis, diabetic neuropathy, hemiplegia, and many other disorders.
3. Is there a positive smear or culture of the material from the ulcer? A positive smear or culture of material from the ulcer may be found in osteomyelitis, tuberculosis, syphilis, anthrax, and other fungal diseases.

DIAGNOSTIC WORKUP

Routine studies include a CBC, sedimentation rate, sickle cell preparation, urinalysis, chemistry panel, VDRL test, smear and culture of the material from the ulcer, and x-rays of the involved area. A biopsy may be necessary to establish the diagnosis. Rarely, a dark field examination will be necessary. Arteriography or venography may establish the level of arterial or venous obstruction. A bone scan will help pin down the diagnosis of osteomyelitis.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

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Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.

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• Back to symptom: Leg symptoms: Introduction (review 1708 causes)
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More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

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