Diagnostic
The basic diagnostic requirement for Foot and ankle practice is X-Ray but the reporting of a foot and ankle x-ray is very different from other x-ray reporting. It requires measurement of different angles between the bones to identify and classify the deformity and it is a very specialized skill. Only a specially trained radiologist or Foot & Ankle specialist surgeon can do this measurement. CT scan and MRI also play a major role in specialized Foot & Ankle practice. The future is coming with weight bearing CT scan of foot and this will replace the requirement of traditional CT scan and also will add value to MRI and x-ray.
Diabetic foot care practice is a very different era of practice and requires a different set of investigation equipment. Detection of vascular supply deficiency and neurological insufficiency of foot is key stone investigation tool for diabetic foot practice. Various type vascular doppler is used to calculate the difference of arterial pressure and the ratio between ankle and brachial arterial pressure to determine the ischemia of foot.
Monofilament neuropathy kit and vibrasiometer are the common instrument is being used to detect loss of vibration, temperature and touch sensation which are very sensitive in early neuropathy detection even before a patient can appreciate. Both the ischemia and neuropathy are key prognostic factor in diabetic foot.
Podiastat or foot pressure scanner is used to detect abnormal pressure point in sole while static and dynamic weight bering. This information is important to offload abnormal pressure and prevent any corn and callosities formation as well as maintain health of sole fat pad. All these cumulatively helps prevention of diabetic foot ulcer or infection development.
Foot scanner is a new tool in foot & ankle practice. This machine take 3D images of foot and provides information for patient specific information for production customised insoles and foot orthotics. Foot insoles and orthotics are required for both diabetic foot care and other foot & ankle deformity as a conservative and preventive treatment.