This disclosure relates to a computer-implemented system and related methods for the design, evaluation, and/or manufacture of protective patient footwear, such as shoes, braces, boots, casts, corrective footwear, and orthoses. The system includes suitable hardware, software, and related peripherals, which function to acquire data related to the patient's particular footwear needs, such as by image capture, including three-dimensional scanning. The system may also acquire data through other sources of input, such as through one or more sensors for detecting various physiologic parameters associated with the lower extremity, or through input of medical conditions, prior indicators, exam, analysis, lab results, or the like, such as through medical practitioner input or other input protocols. The various inputs may be suitably processed to generate output in the form of a design accommodation to design or modify the protective patient footwear, or in the form of one or more medical evaluations or recommendations.