BMJ Case Reports 2017; doi:10.1136/bcr-2017-219465
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An uncommon cause of warm foot

  1. Nihal Thomas3
  1. 1 Department of Endocrinology, Christian Medical College, Vellore, India
  2. 2 Department of Nuclear Medicine, Christian Medical College, Vellore, India
  3. 3 Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India
  1. Correspondence to Dr Nihal Thomas, nihal_thomas{at}
  • Accepted 21 June 2017
  • Published 16 July 2017


A 66-year-old man presented with swelling and redness of right foot of 1 month duration. He was a known diabetic for 20 years; glycaemic control was suboptimal. There was no history of trauma, fever, ulcer or deformity. He had numbness of both feet and was earlier documented to have mild non-proliferative diabetic retinopathy. On examination, he was not feverish with erythema, swelling (figure 1), local rise of temperature of the right foot and a difference of 2°C between both feet and no tenderness on palpation. There was loss of protective sensations with absent ankle jerks with bounding pulses in both feet. Systemic examination was unremarkable. His blood investigations revealed haemoglobin of 12 g/dL (N 12–15), total white cell count of 9.8x109 /L/cmm (N 4000–11000), erythrocyte sedimentation rate of 48 mm/hour and haemoglobin A1c of …

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