Forefoot / Midfoot · Diabetic Limb & Charcot · Infection & Wound · Standard
Smelly Toe
Podiatric surgery residency interview case. Work through it the way you would at an interview: take the history, ask for the exam and imaging, then commit to a diagnosis and plan.
Chief complaint
"The sore on my big toe is draining and smells."
46-year-old male with diabetes seen in the podiatry clinic.
History of present illness
Ulcer on the plantar-medial right great toe present for several months. Over the last 3 days it has started draining and smells.
- Painless (neuropathy)
- No fever or chills
- Has been walking in regular sneakers; no offloading
- Blood sugars have been running higher than usual
Questions a strong candidate asks at this step
- Duration and how it started (shoe, callus, trauma)
- Recent change: drainage, odor, color, swelling
- Constitutional symptoms; glucose control
- Prior ulcers and treatment; offloading
- Pain (neuropathy)
Present the rest of the case
Past history, exam, imaging, assessment, plan and discussion questions, with model answers, are in the interactive trainer. The diagnosis is kept there on purpose so you can practice committing to one.