Volume 15 - Issue 10 - October 2002

Feature »

Getting A Better View With High Resolution Ultrasound

By Paul R. Quintavalle, DPM | 6266 reads | 0 comments

Ultrasound imaging has played an integral role in medical diagnostics for many years. Recent advances in image quality and resolution have now made it possible to examine living tissue ultrasonically at a microscopic level. Indeed, the use of ultrasound biomicroscopy is of growing interest and great importance.1 Advances in computer technology have paved the way for currently available ultrasound units that are portable and cost-effective for office practice.
Indications for diagnostic ultrasound of the foot and ankle include the prevention and treatment of wounds, detecting tendo



Feature »

What You Should Know About COX-2 Inhibitors

By Matt Rampetsreiter, DPM | 10080 reads | 0 comments

Are COX-2 inhibitors good alternatives to nonsteroidal antiinflammatory drugs (NSAIDs)? Yes, traditional NSAIDs inhibit both COX enzymes but they have well-documented gastrointestinal side effects. NSAIDs can cause severe electrolyte disturbances and renal complications such as hyponatremia, hyperkalemia, edema, hypertension, acute and chronic tubulointerstitial nephritis, papillary necrosis and glomerular lesions. Patients with prostaglandin-depleted disease states (cirrhosis, congestive heart failure, chronic renal failure, volume depletion, and nephrosis) who use NSAIDs often develop acute



Feature »

A Comprehensive Review Of Pediatric Orthoses

By Russell G. Volpe, DPM | 18043 reads | 0 comments

Most orthoses made for children are motion-controlling or motion-altering, often referred to as functional foot orthoses. The presenting pathology in the child’s lower extremity often requires a device to reduce excessive motion in a foot with, for example, high ligamentous laxity and genu valgum or you may need the device to direct motion in a limb with a rotational disorder such as a femoral antetorsion and compensatory hyperpronation.
Accommodative devices are less frequently required in this age group. It is much more common in adults than in children to require accommodation of reduced



Point-Counterpoint »

Maggot Therapy: Is It Viable In Wound Care?

By David G. Armstrong, DPM, and Gary M. Rothenberg, DPM, CDE | 10574 reads | 0 comments

Yes, maggots are inexpensive, practical and can facilitate the use of other modalities, says David G. Armstrong, DPM.

I remember bringing up the issue of using maggots to help debride a particularly intractable wound with one of my great mentors, Bill Todd, DPM, who is now with the Dr. William A. Scholl College of Podiatric Medicine at Finch University. What was his response? “Armstrong … Those damn critters have a hell of a lot less education than we’ve wasted on your sorry cranium. I should hope that you can at least learn to debride a wound as well as one of them.”
While I ofte



Forum »

Mending Damaged Feet And Damaged Trust

By John McCord, DPM | 4136 reads | 0 comments

The middle-aged woman was a new patient in my office. Her sparse short hair told me she had recent chemotherapy. Her history confirmed she had been treated for breast cancer during the past three years. Then she slipped her shoes off and I immediately noticed severe hallux varus deformities on both feet. Her question was simple, “What has happened to my feet?”
She explained she had undergone bunion surgery in another state just before her breast cancer was diagnosed. The first toes protruded out at the first postoperative visit. Her surgeon was a well-trained young podiatrist whom she rem



Editor's Perspective »

Are DPMs Sleeping On HIPAA?

By Jeff Hall, Editor-in Chief | 1718 reads | 0 comments

Procrastination is one thing, but the numbers of physicians who have applied for the one-year extension on complying with the Health Insurance Portability and Accountability Act (HIPAA) is extremely low. One consultant notes (as this issue went to press) that less than 4 percent of members of the American Medical Association (AMA) have filed for the extension. Those who don’t file for the one-year extension on October 15 will be expected to be HIPAA compliant on October 16, according to the Centers for Medicare and Medicaid Services (CMS).
While there are no specific numbers on how many D



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