Volume 21 - Issue 6 - June 2008

Diabetes Watch »

Understanding The Impact Of Diabetic Neuropathy On Gait

By Gordon Zernich, CP, BOCPO, Tomas Dowell, CPO, LPO, and Ronald B. Tolchin, DO, FAAPM&R | 19421 reads | 0 comments

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 »

When A Patient Presents With Symmetrical Lesions On The Toes

By M. Joel Morse, DPM | 17959 reads | 0 comments

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 »

Pertinent Roundtable Insights On Indications For Orthotic Management

Guest Clinical Editor: Ronald Valmassy, DPM | 11652 reads | 0 comments

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

Feature »

What You Should Know About Planal Dominance And Pronated Feet

By Edwin Harris, DPM

| 26273 reads | 0 comments

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

Feature »

Emerging Concepts In Shockwave Therapy

By Lowell Weil, Jr., DPM, MBA | 10356 reads | 0 comments

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

Continuing Education »

A Guide To Topical Steroid Use For Dermatological Conditions

By M. Joel Morse, DPM | 4913 reads | 0 comments

Please click here for the full Continuing Medical Education article:


Given the wide variety of topical steroids, this author reviews the potency and absorption of these agents, the pros and cons of different formulations, and potential side effects.