Confused re diagnosis of PAD vs Peripheral Neuropathy

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hello,

i have just joined a new clinic that has a lot of high risk clients. i am confused about differentiating between diagnosis of PAD or Peripheral Neuropathy as the symptoms are similar making it hard for me to give a definate diagnosis.
can any one give me advice in differiencing between both conditions or journals to read that will reduce my anxiety assessing patients.

thank you all for any help you can give me

Helen

new graduate

 

Hi Helen
this is a pain questionnaire that might help with your diagnosis.

http://www.virtualmedicalcentre.com/calc_pfizer_pain_detect.asp

Welcome to the forum

 

Hi Helen,
There are a lot of research papers available on the net, a good place to start to help answer your questions, would be:

NEUROPATHY: ​

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PAIN DAMAGE​

AND THE DIABETIC FOOT

and
ASSESSING THE VASCULAR

STATUS OF THE FEET FOR​

PATIENTS WITH DIABETES
It is said that 50% of diabetic foot ulcers are classified as neuroischaemic, meaning that it is likely that even in early stage disease you will see changes in the feet, which are influenced by both etiologies.
The full version to the mburton's pain questionnaire is here .
Hope this is helpful.

 

Often in longstanding diabetes, there is a significant overlap of these two conditions; however the two are easily distinguished from another with practice!

It is a definite good idea to review your journal articles in order to wrap your head around their respective definitions.

Clues regarding PAD:
* the temperature gradient from the knees down to the toes is noticeably colder towards the feet and toes.
* look for mottled discolouration, lack of hair growth, thin shiny skin, thickened toenails
* enquire about intermittent claudication
* conduct ABPI (note the false positives with diabetic calcification)

Clues for Peripheral Neuropathy:
* the patient uses words like "numb, tingly, tight-sock sensation, burning"
* note the profession of the disease i.e usually starts in one or two toes of one foot, but gradually moves to the other foot and gradually moves proximal up the leg
* anhidrotic skin in the case of autonimic neuropathy
* conduct protective pressure sensation and vibratory sensation

The "pain/discomfort" of PAD is generally felt when the patient is active (besides REST PAIN, which is felt even at rest!); while the "pain/discomfort" of PN is generally felt when the patient is at rest.

Hope this helps Helen :empathy: