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Diabetic Foot Files

Monckeberg Sclerosis: The Silent Vascular Threat in Diabetic Feet

12 min10 september 2025

This episode explains Monckeberg ("Mockingbird") sclerosis—a medial arterial calcification common in diabetes and chronic kidney disease—how it stiffens arteries without narrowing the lumen, and why it can make ABI results falsely reassuring.

Learn how to spot the classic railroad-track calcifications on x-ray, which vascular tests to use instead (toe-brachial index, duplex ultrasound, TcPO2), and why multidisciplinary care and optimized medical management are essential.

The episode covers practical steps for diagnosis, monitoring, and treatment planning to prevent delayed care and improve limb salvage outcomes in diabetic foot patients.

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