Small Wound, Severe Pain: Recognizing Sickle Cell Foot Ulcers

Dr. G explains how sickle cell disease causes rigid, sickled red blood cells that block microvasculature, producing severe pain and tissue ischemia that can lead to foot ulcers. The episode covers pathophysiology, triggers of vaso-occlusive crises, screening and confirmatory tests (including hemoglobin electrophoresis), and how sickle cell ulcers differ from diabetic and venous ulcers. Clinical pearls include pain disproportionate to wound appearance, common ulcer locations (around the malleoli), higher infection and osteomyelitis risk (notably Salmonella), and the need for gentle debridement, oxygenation, hydration, infection control, and multidisciplinary care.