ABSTRACT
Osteomyelitis often complicates a diabetic neuropathic foot, leading to amputation, decreased function, and quality of life. Therefore, early detection and treatment are paramount. Furthermore, neuroarthropathic (Charcot) changes in the foot often resemble infection and must be differentiated. Currently, the Tc-99m HMPAO Labeled Leukocytes Scan is considered to be the most reliable noninvasive imaging modality of choice in determining Charcot foot changes versus osteomyelitis. The purpose of this article is to alert the clinician that although the Tc-99m HMPAO Labeled Leukocytes Scan may be the second most reliable test next to bone biopsy for determining osteomyelitis, false positives do occur.
Subject(s)
Arthropathy, Neurogenic/diagnostic imaging , Foot Diseases/diagnostic imaging , Osteomyelitis/diagnostic imaging , Radiopharmaceuticals , Technetium Tc 99m Exametazime , Acute Disease , Aged , Diagnosis, Differential , Humans , Male , Radionuclide ImagingABSTRACT
It is unusual to find such extensive deformity of the navicular in a bilateral and symmetrical fashion. The apparent lack of significant trauma coupled with the patient's unremarkable medical history led the authors to an exclusionary diagnosis of spontaneous osteonecrosis. While changes are clearly evident on plain film radiography, computed tomography and magnetic resonance imaging provide the clinician with a more detailed picture of the extent of destruction.
Subject(s)
Osteonecrosis/diagnosis , Tarsal Bones/pathology , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
In diagnosing the etiology of tarsal tunnel syndrome, the practitioner must be aware of space-occupying lesions as a possibility. These masses, rarely found beneath the laciniate ligament, can occur. Satisfying results have occurred after removal of these lesions. Careful dissection will assure preservation of the nerve and prevent sensory or motor loss.
Subject(s)
Lipoma/complications , Neurofibroma/complications , Peripheral Nervous System Neoplasms/complications , Skin Neoplasms/complications , Tarsal Tunnel Syndrome/etiology , Tibial Nerve , Adult , Female , Humans , Middle AgedABSTRACT
A case study has been presented where C. jeikeium was isolated as the causative bacterium of an osteomyelitis of the fifth metatarsal. Partial amputation, local wound care, frequent and aggressive debridement, and appropriate antibiotics were all used with apparent success. The lack of complete patient follow-up prohibits the authors from declaring the infection cured; however, all signs of infection were absent immediately prior to discharge. The authors believe this to be the first reported case of Corynebacterium species as the bacterial isolate in confirmed osteomyelitis.
Subject(s)
Corynebacterium Infections , Corynebacterium/isolation & purification , Metatarsus , Osteomyelitis/etiology , Corynebacterium Infections/drug therapy , Debridement , Humans , Male , Middle Aged , Osteomyelitis/drug therapy , Osteomyelitis/surgery , Vancomycin/therapeutic useABSTRACT
The authors present an overview of varus or curly toe deformity. This congenital deformity can be seen in many generations of the same family, with no greater incidence in males or females. The hereditary influences on the inheritance of this deformity have not been clearly defined but appear to follow an x-linked or autosomal dominant pattern. The deformity is very often dismissed by physicians, and if left untreated can lead to more serious digital pathology later in life.
Subject(s)
Foot Deformities, Congenital/surgery , Toes/abnormalities , Child, Preschool , Humans , Male , Toes/surgeryABSTRACT
The purpose of this manuscript is to introduce an alternative method of performing triplane Austin bunionectomies using a 0.062-inch Kirschner wire for fixation. This procedure was employed in clinical situations where there was an elevated first ray and/or a submetatarsal two lesion intractable plantar keratoma. X-ray criteria include a mild to moderate increase in the intermetatarsal angle (IMA) and a proximal articular set angle (PASA) deformity. Elevatus of the first ray is evident. Thirty-six cases were reviewed over a 5-year period. Follow-up ranged from 6 months to 3 years. Statistical results support the use of this capital osteotomy for the reduction of intermetatarsal angle and proximal articular set angle, and to plantarflex the first ray. Early mobilization with return of function of first metatarsophalangeal joint (MPJ) range of motion makes this an ideal procedure for the podiatric surgical patient who needs to return to activity as soon as possible.
Subject(s)
Hallux Valgus/surgery , Osteotomy/methods , Follow-Up Studies , Hallux Valgus/diagnostic imaging , Humans , Mathematics , Radiography , Retrospective StudiesABSTRACT
The authors discuss the use of computers in medicine. A patient presenting with a condition requiring surgery is represented by a data file in a computer program. The user obtains data from the file by selecting items from a menu. Data are presented on the screen in pop-up windows. By examining the data and making judgments, the user may determine the pathology and make first a provisional and then a definitive diagnosis.
Subject(s)
Computer Simulation , Computer-Assisted Instruction/methods , Diagnosis, Computer-Assisted , Foot Diseases/diagnosis , Podiatry/education , Software , Pilot ProjectsABSTRACT
The purpose of this article is to show the possibility of using fetal membranes as a biologic dressing for some of the pedal ulcerations that podiatrists encounter. There are as many treatment modalities for lower extremity ulcerations as there are types of ulcers. Through the following case histories, the authors demonstrate various types of ulcerations treated with amnion and chorion and the results achieved. The clinical application of fetal membranes has been under study for many years. The authors' efforts support the use of amnion and chorion by the medical community in treating some lower extremity ulcers.
