Evaluate the weightbearing pattern of the forefoot and adjacent metatarsals. Diagnostic Injection -Anesthetize the metatarsophalangeal joints with local anesthesia. If pain resolves then diagnose synovitis or capsulitis. If pain fails to resolve consider extra-articular pathology, possibly neuroma. The focus of this presentation is the identification of simple wounds versus severe wounds in which limb loss is of great concern.
Pulses are a means of evaluating large vessels.
With microvascular disease pulses may be palpable. Capillary filling time is a functional test. If you sense any level of ischemia get a vascular study or vascular surgery consultation. If test positive, with lack of sensation, patient has lost protective threshold and is at risk of unrecognized trauma. No pain with wound debridement or probing.