Volume 18 - Issue 3 - March 2005
Diagnostic Dilemmas »
Problems with the lateral column are more common than we believe. Although there is a great deal of understanding of medial column problems and their solutions, there is not as much information on lateral column symptoms, causes and treatment options. With this in mind, let us take a closer look at these potential symptoms and treatment options that our institute has found helpful for such problems.
A typical patient may have an equinus and pain in the lateral foot and ankle. The pain is localized to the rearfoot and lateral ankle with tenderness along th
News and Trends »
The potential side effects of nonsteroidal antiinflammatory drugs (NSAIDs), including COX-2 inhibitors, have been well documented recently. The highly publicized Public Health Advisory from the Food and Drug Administration on celecoxib (Celebrex) and rofecoxib (Vioxx) has increased the discussion about the safety of such agents. What types of side effects should one be wary of with NSAIDs and COX-2 inhibitors, and what screening precautions can one take?
Nicholas Grumbine, DPM, has seen gastrointestinal (GI) difficulties and bleeding in patients taking
Surgical Pearls »
Back when I left the didactic world of podiatry school and entered my residency, I was ready for a transition that would blend the books with practice. Of course, the first two surgeries I performed did not fit the mold. The first one was a cartilage articulation preservation procedure (CAPP) and the other was a Keller procedure.
The CAPP procedure was familiar to me only in books and the Keller seemed “outdated.” To my surprise, both surgeries turned out well and gave me an appreciation that diverse types of procedures can have a good outcome when t
Wound Care Q&A »
While there is quite an array of choices when it comes to choosing appropriate wound care modalities for lower-extremity wounds, there is not, as one panelist points out, a lot of published evidence for guidance. With this in mind, our expert panelists discuss a variety of wound care scenarios and how their clinical experience guides their decision-making on dressings and debriding agents.
Q: Given the multitude of wound care dressings available, how do you narrow down your choice of wound dressings?
A: Eric Espensen, DPM, and
Foot ulcers are a major predictor of future lower limb amputations. Fourteen to 24 percent of patients with diabetes with foot ulcers eventually require an amputation and more than 60 percent of nontraumatic lower extremity amputations occur in those with diabetes.1,2 Although risk factors may vary, the majority of diabetes-related amputations result from peripheral arterial disease, peripheral neuropathy or infection.3
The healthcare costs associated with diabetic foot infections are staggering. In an analysis of medical and pharmac
Neuropathy is a common and debilitating complication of diabetes mellitus. According to data compiled by the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) and the American Diabetes Association (ADA), roughly 60 to 70 percent of the 18.2 million Americans with diabetes will develop some form of diabetic neuropathy and about 3 million patients with diabetes will experience painful neuropathy.
There are three broad types of neuropathy (sensory, motor and autonomic) associated with diabetes. Sensory neuropathy is the most prevalent