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Dear all,

Would any one be able to assist explaining why many of my diabetes suffering patients get woody limbs especially following amputations...?

is it to do with potassium?

Thanks

 

I have no idea what you are talking about!

 

limited medical history as patient transferred from private institute and the family was unaware of most things.

We need to run more tests in the hospital but so far...

diabetes nid diagnosed last year
right leg aka
abpi 0.8
pitting oedema.

The doc suggests that the creatine levels are likely to be high and albumin is probably very low. I understand in basic terms why the leg would swell/oedema but just not why it has gone so hard.

I'm dressing wounds and doing the non invasive vascular assessment, toe pressure next appointment. I just wondered how the high creatine and low albumin can lead to hard lower limb or if this is completely irrelevant.

cheers

 

Are you talking about the stump or the contralateral limb?
Ros

 

Hi Ros,

it's the contralateral leg

 

There are several issues here. Kidney disfunction being high on the agenda, either +/- diabetes, muscle trauma due to amputation. ABI may not give an accurate indication of the blood supply to the contralateral limb. A vascular lab assessment is indicated particularly if there are wounds. This sounds like a critical situation for the remaining limb and getting this patient mobile again. A multi disciplinary approach is strongly indicated.
Hope this helps.
Ros

 

Great, cheers. All labs booked for Wednesday.

 

woody leg...lipodermatosclerosis?

 

one of the signs of Lymphoedema is Woody appearance/feeling. Jua a thought

 

thanks.

I'm pretty new to all this, googling and discussing lymphoedema seemed to suggest that it would likely exhibit more swelling, it's just thin and hard.

I sent a photo to my old dermatology prof and agreed and explained the reason, Cheers David