Distal posterior heel pain is a deformity we see quite often. It masquerades as chronic Achilles tendinitis, when in fact a calcaneal step (aka retrocalcaneal exostoses) is present at the Achilles insertion. You must also clinically differentiate it from adjacent problems, such as Haglund’s deformity, retrocalcaneal bursitis and intra-Achilles tendon tear. Often, these problems may be concurrent, however, you must treat the calcaneal exostoses for complete cessation of pain. Keep in mind that retrocalcaneal exostoses are most symptomatic in active individuals over 30.
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Diabetes is considered one of the most psychologically and behaviorally demanding of the chronic medical illnesses. Patients with diabetes are particularly vulnerable to depression. Indeed, up to one in every three diabetics has depression at a level that impairs functioning and quality of life, and lowers adherence to glucose monitoring, exercise, diet, medication regimes and glycemic control. As a result, depression increases the risk of long-term diabetic complications.
When you use self-reporting surveys as a gauge, you’ll find an even broader spectrum of depressive illness in diabetic