Hemochromatosis of the foot and ankle. Report of three cases and review of the literature.

Genetic hemochromatosis is a disorder of iron metabolism that results in deposition of massive amounts of iron in the tissues. Arthropathy is one of numerous clinical manifestations associated with this disease. Characteristic radiographic features have been reported in the hand and wrist, and the hip; however, there is no mention in the literature of joint manifestations in the foot and ankle. In this report, the authors present three patients with hemochromatosis arthropathy of the foot and ankle. Two patients presented primarily with foot pain and were treated initially with orthoses. One of these patients went on to have to midfoot arthrodesis performed. The third patient presented with ankle joint symptoms, and was treated successfully with an ankle foot orthosis. The arthritis of hemochromatosis has classic radiographic findings. However, the arthritis of hemochromatosis may be difficult to differentiate from several other joint diseases. Characteristic features of this disease in the foot and ankle are discussed.

Practice versus family: the great balancing act.

Dairy practice often requires substantial time commitments. Those veterinarians with families may find that if they do not actively budget some time for spouse and children, the family unit may suffer. A successful practice and meaningful family life are both possible if the doctor or doctors involved are willing to work for their achievement.