امرأة عمرها ٦٦ سنة عندها سكري، جاءت بألم وتورم واحمرار في القدم اليسرى بدون جرح، والقدم أدفأ من اليمنى بوضوح، والنبض جيد، والحرارة طبيعية. عندها اعتلال أعصاب شديد. ماذا يجب أن يُستبعد؟

A 66-year-old diabetic woman has a painful, swollen, red left foot without a wound; it is clearly warmer than the right, pulses are good and temperature normal. She has severe neuropathy. What must be excluded?

1. Ordinary gout treated with an NSAID only
2. Poor circulation needing massage with cream
3. A simple sprain, so keep walking on it as usual
4. Charcot foot, needing offloading and urgent imaging

Answer: D) Charcot foot, needing offloading and urgent imaging. Charcot neuroarthropathy causes a hot swollen foot in neuropathic clients and may be misdiagnosed as infection. Immediate offloading (cast) and imaging prevent deformity.