Annual foot assessment stratifies risk from three findings: protective sensation (a 10 g monofilament at the defined sites, or a 128 Hz tuning fork), pedal pulses, and any structural deformity, callus or skin breakdown. Loss of sensation, absent pulses, deformity or a previous ulcer each moves a patient up the risk ladder and shortens the review interval.
Previous ulceration or amputation is the single strongest predictor of a future one, so those feet need the shortest intervals and a footwear review. Record the risk category, not just that feet were examined, so the next clinician can act on it.
- Check protective sensation with a 10 g monofilament or 128 Hz tuning fork at every annual review.
- Palpate pedal pulses and inspect for deformity, callus and skin breakdown.
- A previous ulcer or amputation is the strongest predictor of the next, so shorten the interval.
- Document the risk category, not just that the feet were examined.
Why it matters
Structured annual stratification is what catches the high-risk foot before it ulcerates.
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