Volume 19 - Issue 3 - March 2006
Diabetic peripheral neuropathy (DPN) is a “diagnosis of exclusion.” Diagnostic challenges are one thing but few practitioners relish that phrase when it comes to DPN.
For this condition, the practitioner needs to cast a very wide net of tests and keep an open mind regarding clinical suspicion in order to reach an accurate diagnostic conclusion. How likely is it that there could be another neuropathy-causing disease or medical condition resulting in these same lower extremity symptoms? Does the podiatric physician really need to consider thyroid problems, vitamin B12 deficiencies, nerve en
The goal of soft tissue coverage is to restore form and function. However, due to the anatomic complexity of the foot and ankle, soft tissue coverage in this area often falls short of Sir Harold Gillies’ adage to “… replace like with like.”1,2 Ideally, soft tissue coverage of the foot and ankle would involve primary repair free of tension and utilize neighboring sensate native tissue that is capable of withstanding the forces sustained during gait.1-3
Soft tissue wound coverage employs various forms of conservative and surgical techniques aimed at creating rapid
Nearly 21 million people in the United States have diabetes, according to the Centers For Disease Control and Prevention (CDC). Approximately 6.2 million of these people are not aware they have the disease. The CDC also estimates that over 40 million people have pre-diabetes, a condition that increases the risk of developing type 2 diabetes. Over 20 percent of adults 60 years of age and older have diabetes.
Fees are down, expenses are up and the days of fat profit margins for physicians are over. Managed care in some form is here to stay. The tidal wave of baby boomers approaching retirement suggests the pendulum will not swing back to the “good old days” of fee-for-service medicine.
The U.S. government, the payer for more than 50 percent of the covered population, continues to ratchet down reimbursement. Accordingly, many doctors are now working harder than ever. Unfortunately, they are also prone to irrational investing behavior and making more investment mistakes than ever before.
Continuing Education »
Due to the nature of the disease, the diabetic patient population has an increased risk of developing nail abnormalities, including onychocryptosis, onychomycosis and other nail structure malformations and injuries. Over one-third of diabetic patients suffer from nail abnormalities and are 2.77 times more likely to have nail mycoses compared to the general population.1
Treatment Dilemmas »
As practitioners of the foot and ankle, some conditions and their treatment options become second nature to us. For example, it seems we are fairly comfortable with the treatment options associated with a degenerated first metatarsophalangeal joint. However, what does one do with the patient who has pain at the ball of the foot when X-rays reveal flattening of the second metatarsal head and degenerative changes in the second metatarsophalangeal joint? The answer probably should be, “Well, it depends.”
Freiberg’s disease can vary in severity and typically undergoes a progression over tim
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