Volume 18 - Issue 4 - April 2005

Editor's Perspective »

Ethics And The FDA: Is It Time For A 'Priority' Review?

By Jeff Hall, Executive Editor | 1804 reads | 0 comments

   Is objectivity much of a priority in studies of new medications? Granted, pharmaceutical companies have the wherewithal to support funding of these studies. Without that funding, some of the leading advances in new medications may not be possible. However, the companies also have a vested interest in the results of these studies and you have to wonder if that vested interest casts an imposing shadow at times on those doing the research.

   One DPM says he has “rarely felt any pressure” in the research studies he has participated in over the years. He say



Continuing Education »

Expert Insights On Diagnosing Pigmented Skin Lesions

By Bradley W. Bakotic, DPM, DO | 11086 reads | 0 comments

   During the course of a tightly scheduled office day, a 30-year-old female presents with a painful paronychia involving the lateral border of her right hallux. The painful nail border is acutely inflamed. The doctor temporarily defers a definitive chemical matrixectomy and opts to perform a “slant-back” procedure to remove the offending nail border.

   The doctor adducts the patient’s foot ever so slightly to access the problematic portion of the affected nail unit more easily. While doing so, the clinician notices a tan/brown, slightly elevated papule



Feature »

Troubleshooting AFOs

By Lawrence Z. Huppin, DPM | 15243 reads | 0 comments

   In 1996, Douglas Richie Jr., DPM, introduced the first ankle foot orthosis (AFO) to incorporate a functionally balanced foot orthosis. Podiatrists have long utilized AFOs to control ankle joint motion. However, the AFO designed by Dr. Richie was the first AFO to also provide the benefits of functional correction of the foot. These additional benefits included greater control of the subtalar joint, midtarsal joint stability and enhancement of the windlass function.

   The result was a rapidly accepted new modality that became a primary treatment in the podiat



Feature »

How To Handle Second MTPJ Stress Syndrome

By Joshua Gerbert, DPM | 61752 reads | 0 comments

   Second MTPJ stress syndrome has become a catch-all term for patients who complain of chronic pain involving the second MTPJ. While it is important to differentiate this entity from a neuroma, intermetatarsal bursitis or a stress fracture of a metatarsal, it is even more important for the practitioner to determine an accurate etiology or etiologies for the second MTPJ stress syndrome. Only by understanding the cause of the problem can one develop an effective treatment plan.

   When a patient has second MTPJ stress syndrome, he or she may have the following



Feature »

What You Should Know About New Antirheumatic Medications

By Peter A. Blume, DPM, Kenneth L. Cornell, DPM, and Robert Schoen, MD | 5275 reads | 0 comments

   Rheumatoid arthritis (RA) is a systemic inflammatory polyarthritis that involves small and large joints, and affects approximately 1 percent of the population in the United States.1 The natural progression of the disease leads to irreversible deformity in the hands and feet with destruction of bone and articular cartilage. This may ultimately lead to the loss of function of the extremity. There are numerous extraarticular manifestations of RA (i.e., including vasculitis). They can affect any organ system and result in premature death.

   Over the



Feature »

How To Master Talonavicular Fusions

By William Fishco, DPM | 42771 reads | 0 comments

   The talonavicular joint arthrodesis has been utilized for a variety of pathologies of the foot. Instability and subluxation of the rearfoot in adult acquired pes valgus is the most common reason for rearfoot fusion. Congenital deformities, neuromuscular diseases and arthritic conditions, whether they are from an inflammatory arthritis, osteoarthritis or posttraumatic causes, are less common pathologies that would require fusion of the talonavicular joint.1

   In a rigid rearfoot deformity, such as a multiplanar deformity with heel valgus, forefoot