Painless Plantar Ulcer Under in Medicine / Internal Medicine — 62yo Man | Endocrinology | SMLE Q#12053
SMLE Question #12053
Medicine / Internal Medicine
Endocrinology
Objective: OBJ-ADDISON-DOSE-1
Last updated: February 2026
A 62-year-old man with poorly controlled type 2 diabetes mellitus presents with a painless plantar ulcer under the head of the first metatarsal on the right foot, first noticed 3 weeks ago. Examination shows a 2-cm well-demarcated plantar ulcer with granulation tissue. He has reduced vibration and light-touch sensation over the plantar surface. Dorsalis pedis and posterior tibial pulses are 2+ and symmetric bilaterally, and the foot is warm. The clinician wants to confirm the underlying etiology of this ulcer to guide long-term management. What is the most critical test to perform to reach the diagnosis?
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