Difference between revisions of "Trench foot"
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Diagnosis== | ==Diagnosis== | ||
Revision as of 12:09, 18 July 2015
Contents
Background
- Develops slowly over hours-days when foot is exposed to cold/wet conditions
- Reversible injury may progress to irreversible injury
Clinical Features
- Tingling/numbness is initial symptom
- Foot appears pale, mottled, anesthetic, pulseless, and immobile
- Initially does not change after rewarming
- Hyperemic phase begins w/in hr after rewarming
- Assoc w/ severe burning pain and reappearance of proximal sensation
- As perfusion returns to foot over 2-3d edema and possibly bullae may form
- Anesthesia persists for weeks and may be permanent; gangrene may occur
Differential Diagnosis
Foot diagnoses
Acute
- Foot and toe fractures
- Subtalar dislocation
- Metatarsophalangeal sprain (turf toe)
- Acute arterial ischemia
- Calcaneal bursitis
Subacute/Chronic
- Diabetic foot infection
- Peripheral artery disease
- Plantar fasciitis
- Trench foot
- Ingrown toenail
- Paronychia
- Tinea pedis
- Morton's neuroma
- Diabetic neuropathy
Cold injuries
- Generalized
- Freezing
- Non-freezing
Diagnosis
- Usually clinical
Treatment
- Keep feet clean, warm, dryly bandaged, elevated
- Monitor for signs of infection