Volume 21 - Issue 6 - June 2008
Diabetes Watch »
Sensory neuropathy is the most common form of diabetic neuropathy. Nerve damage results from poorly managed and chronically high levels of blood sugar. In patients who have type 1 diabetes, which usually affects those 25 years and younger, there is insulin deficiency. In regard to people with type 2 diabetes, their insulin production inadequately meets the body’s daily need to metabolize sugar and starches found in such foods as bread, potatoes, rice and corn.
In sensory polyneuropathy, nerve damage occurs many years after the onset of type 1 diabetes and poor glycemic m
Dermatology Diagnosis »
A 32-year-old Caucasian female presents to the office with swollen, sore, irritated, itchy toes of both feet and a symmetrical distribution on the tops of the toes.
She notes that the redness started four weeks ago. It was on the third toe initially but is now on other toes as well, according to the patient. There is no scaling or maceration in the interspaces, and no scaling on the rest of the foot.
Orthotics Q&A »
Choosing the most effective type of orthotic device for a given condition can be tricky as one must consider factors that include materials, potential modifications and cost.
Accordingly, the panelists discuss possible indications for OTC orthoses, conditions that are particularly challenging to treat with orthotics and the role of functional foot orthoses in managing bunion deformities.
Q: Are all prefabricated, over-the-counter (OTC) foot support systems essentially the same? Are there unique characteristics of any of the devices which makes them better s
It is unfortunate that the terms pes planus and flatfoot are so ingrained in the medical literature because they concentrate attention on only one component of a very complex deformity. Smith and Ocampo described a classification for pes “pronatus” based on an earlier work by Borelli and Smith that identified the dominant plane of the deformity.1,2 Although it was originally designed for surgical procedure planning, it is equally ideal for non-surgical treatment.
Dating back to the 1970s, biomechanical theory of the pronation syndromes concentrated almost
When musculoskeletal extracorporeal shockwave therapy (ESWT) was first introduced in the United States with the first FDA approval in 2000, there was a great deal of controversy and posturing among manufacturers of ESWT technologies. Each company was determined to create an exclusive market for their product at the expense of the competition. One of the most common targets for criticism was the level of energy of the technology. Based on industry biases, high-energy ESWT was considered the most effective for the musculoskeletal system. Those devices that failed to reach high energy we
Sports Medicine »
Surgeons routinely make treatment decisions based on their training and experience. For example, we typically employ non-operative treatment of Achilles ruptures for the elderly. Surgical repair, on the other hand, is usually recommended for younger, active patients. The traditional teachings on the long-term outcome after Achilles rupture tend to lump conservative treatment of acute rupture with non-operative treatment of delayed presentation and neglected rupture. Surgeons learn that non-operative treatment results in slow healing, weakness, calf atrophy, re-rupture and loss of func
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