Presentation on theme: "Diagnosis and Treatment of Common Foot Conditions"— Presentation transcript:
1 Diagnosis and Treatment of Common Foot Conditions Your Name and address here
2 What is a Podiatrist?Specializes in diagnosis and treatment of conditions effecting the foot, ankle and lower leg in all age groupsAttends one of seven Colleges of Podiatric Medicine for four yearsCompletes a post-graduate residency between one and four years
3 Conditions We Treat Dermatologic Orthopedic Neurologic Diabetes-related foot and ankle ailments
13 Verruca! Human Papilloma Virus (HPV) Contagious Usually plantar on foot
14 Verruca Treatment Debridement is diagnostic and therapeutic ChemocauteryVarious topical treatments availableOral Cimetidine for pediatric usage (30-40Mg/Kg in 3 divided doses)Curretage
15 Plantar FasciitisInflammation and pain of the plantar fascia, usually at its insertion at the plantar medial tubercle of the calcaneousBecomes chronic in 5-10% of all patientsIs not necessarily associated with a heel spurOver 90% resolve with conservative treatment
16 Plantar Fasciitis Symptoms Weight-bearing pain on arisingPain subsides, returns with activityFootwear related to pain?
27 Ankle - Foot Orthosis Articulated hinge device Used when functional orthotic fails or will failFor active patient that can tolerate motionExcellent for sports
28 Ankle – Foot Orthosis Gauntlet style for total control For patients that cannot tolerate motionGood for severe DJD and Charcot foot
29 Ankle SprainsTear or stretching of the ligaments of the ankle. Usually the ligaments on the outside of the ankle are involved.Caused by and twisting injury of the foot / ankle .Instability of the ankle can develop due to the ligament injury.Most often treated conservatively. Surgical repair can be performed to treat chronic ankle sprains.
31 Ankle Sprains Rehabilitation CAM walker to StirrupStirrup to gauntletPhysical therapy
32 Morton’s Neuroma Painful swelling of the interdigital nerve Most commonly seen in third web spacePatients can feel numbness of adjacent digits and plantar painEtiology is abnormal stretching of the nerve
35 Diabetic ulcer Etiology is usually traumatic caused by shoes Bony promonence is usually involved (hammertoe, bunion, plantarflexed metatarsal, bone spur)Often start as a blister, corn or callous
36 Diabetic ulcer treatment Always obtain serial X-rays to rule out osteomyelitisDebride the wound to granular bedRemove hyperkeratosisGently probe wound for deep sinusDress initially with Silvadene creamConsider other wound productsConsider offloading
37 Charcot Joint Diabetic Neuroarthropathy Often involves both pathologic dislocation and fractureUsually effects midfoot, but all lower extremity joints are susceptibleFoot is acutely edematous and warmDeformity is common
38 Charcot Joint Treatment Non-weight bearing for 12 weeksPatient education is critical to outcomeSerial X-rays to document deformityMolded shoe often needed after coalescenceSurgical Treatment
39 Therapeutic Shoes Newly diagnosed + 33% 1990’s Amputations + 28%Medicare has stated that 50% of amputations were preventable
40 Therapeutic ShoesFocal pressure keratosis with accompanying risk factors are the major cause of ulcer.Patients who have regular, frequent foot clinic visits that include risk evaluation, debridement of lesions, prescription of appropriate shoes and patient education are less likely to ulcerate. 11 Sage RA, Webster JK, Fisher SG: Outpatient Care and Morbidity Reduction in Diabetic Foot Ulcers Associated with Chronic Pressure Callus. JAPMA 91:275, 2001.