Podiatry Update

The next ePodiatry Newsletter is online.

Lots of new topics being discussed at Podiatry Arena (much more interesting than all the negativity seen on other forums):
Nerve implantation for drop foot (General Forum)
Cancer metastasis in the foot (General Forum)
Medihoney (General Forum)
Weight gain can trigger foot and ankle pain (General Forum)
Pedometers and podiatry (General Forum)
Genetic component to achilles tendon pathology (Sports Medicine Forum)
Help with a case - athlete rehab (Sports Medicine Forum)
Dark Chocolate & Diabetes (Diabetic Foot Forum)
HBA1c and wound healing (Diabetic Foot Forum)
Cooling the Foot to Prevent Diabetic Foot Wound (Diabetic Foot Forum)
Night-splints - profound soft tissue ankle equinus (Pediatrics Forum)
Motion and Balance in the Aged and Diagnosis (Gerontology Foot Forum)
Medicare Shoe Bill 2005 Rate Changes (USA Forum)
Las Vegas podiatrist convicted in Medicare fraud case (USA Forum)
Government deny chiropody crisis (UK Forum)
Public Relations and Podiatry - what is its role? (Australia Forum)
Podiatry crisis point in Australia (Australia Forum)
Rabbit Valley School of Podiatry (Break Room)

Every few years, there is a case report in the literature of foot pain being either the presenting feature of cancer or occuring in those with known cancer somewhere else in the body (due to a metastasis). Recently, there have been two ..... providing a timely reminder of our importance in arriving at a correct diagnosis:

From: International Urology & Nephrology. 2004;36(3):329-30.
Renal cell carcinoma presenting as solitary foot metastasis. [quote]Skeletal metastases from genitourinary tract are common, but metastatic tumors involving the hand and foot are rare. We herein present a case of 55-year-old man who presented with painful swelling of right foot and no urological complaints. Investigations revealed left renal mass and fine needle aspiration cytology from the swelling revealed findings consistent with metastatic clear cell carcinoma.

From: Onkologie. 2005 Mar;28(3):141-3
Isolated talus metastasis from breast carcinoma: a case report and review of the literature. [quote]Background: Acrometastases are very rare and have been identified in only a few cases on the foot. At the onset, they might be misdiagnosed as arthritis. Case Report: A 59-year-old woman with isolated metastasis to the talus, originating from breast carcinoma was treated by radiotherapy, letrazole, and intravenous bisphosphonates. Results: The review of the literature revealed that this is the first case of an isolated metastasis to the bone of talus from a breast carcinoma, while there are a few cases originating from other organs. The differential diagnosis of acrometastases may be difficult. Conclusion: Pain in the foot or hand of a patient with a known history of malignancy should be considered as potential metastasis.

New from Podiatry Online:
Antibiotic therapy in open fractures
ACFAS Board of Directors endorses model Scope of Practice Act
Ankle bracing to prevent injury during sports

Latest threads at Podiatry Arena:
Weight gain can trigger foot and ankle pain (General Forum)
Help with a case - athlete rehab (Biomechanics Forum)
Help with patient with lateral leg pain (Biomechanics Forum)
HBA1c and wound healing (Diabetic Foot Forum)
Cooling the Foot to Prevent Diabetic Foot Wound (Diabetic Foot Forum)
New Surgical Technique Repairs Arthritic Ankle Damage (Foot Surgery Forum)
Night-splints - profound soft tissue ankle equinus (Pediatrics Forum)
Journal of the American Podiatric Medical Association (Journals Online)
Jury indicts podiatrist for threats (USA Forum)
Model Scope of Practice Act (USA Forum)
APMA's best walking city (USA Forum)
"Hands off our sex lives, puritans" (Australia Forum)
Public Relations and Podiatry - what is its role? (Australia Forum)

The next ePodatry Newsletter is online.

Medscape have a full text article on this (free registration required to access)
A Qualitative Approach to Understanding the Experience of Ulceration and Healing in the Diabetic Foot: Patient and Podiatrist Perspective
Abstract The management of a diabetic foot ulcer requires the patient to change his or her behavior. Despite little evidence, it is suggested that psychological factors are influential in the healing of diabetic foot ulcers. It is, therefore, important to determine how patients with diabetic foot ulcers and the podiatrists who treat them perceive and understand foot ulceration, as this may influence patients' behaviors. To address this gap in knowledge, 2 qualitative studies were undertaken. In the first study, interviews were conducted with 13 patients with diabetic foot ulcers recruited from outpatient podiatry clinics. A second study was conducted with podiatrists working in the outpatient clinics from which the patients were recruited. In both studies, the interview schedules consisted of a series of open-ended questions concerned with examining beliefs about ulcers, causes and treatment of ulcers, and adherence to treatment recommendations. All interviews were tape recorded, transcribed, and coded for emerging themes using the "constant comparison" approach to qualitative data analysis. The experience of having ulcers had a considerable impact on patients' lifestyles. Both ulcer and treatment affected the patient's mobility, independence, and social life. These experiences often lead to anger, fear, depression, helplessness, boredom, and loss of self-esteem. Podiatrists also perceived that foot ulcers had a negative impact on patients' lives and their emotional well-being and were aware of factors that may influence adherence to treatment. It is suggested that understanding and addressing the psychosocial aspects of foot ulceration may lead to better adherence and may improve clinical outcomes.

The next ePodiatry Newsletter is available.

Latest threads at Podiatry Arena:
Foot pain and disability in Ehlers-Danlos syndrome (General Forum)
The effects of foot disease on quality of life (General Forum)
Sport shops leave buyers wrongfooted (Sports Forum)
Qualitative Understanding of Ulceration in the Diabetic Foot (Diabetic Foot Forum)
New Surgical Technique Repairs Arthritic Ankle Damage (Foot Surgery Forum)
Night-splints - profound soft tissue ankle equinus (Pediatric Forum)
Health care fraud inquiries lead to charges (USA Forum)
APMA's best walking city (USA Forum)
Which UK school of podiatry? (UK Forum)
Podiatrist Shortage And Overseas Podiatrists (Australia Forum)

The next ePodiatry Newsletter is online

Latest Podiatry Arena threads:
More Experienced Physicians May Provide Lower Quality of Care (General Forum)MBT's (General Forum)Do foot orthoses weaken "arch" muscles? (Biomechanics Forum)Sport shops leave buyers wrongfooted (Biomechanics Forum)Sensory effects of foot orthoses (Biomechanics Forum)Removeable and irremovable cast walkers (Diabetic Foot Forum)Foot & Ankle International (Journal Online)Knee Seminar (USA Forum)Podiatrist pleads guilty in assaults (USA Forum)Podiatrists To Pay $574,014 Settlement For Medicare Over Billing (USA Forum)Bay Area podiatrist accused of fraud (USA Forum)Podiatry vs. Chiropody (UK Forum)Which UK school of podiatry? (UK Forum)Podiatrist Shortage And Overseas Podiatrists (Australia Forum)Clinical Biomechanics Boot Camp #3 (Australia Forum)Docs work on monk who glued eyes shut

4 interesting articles:
What You Should Know About NSAIDs
MRSA: Where Do We Go From Here?
Current And Emerging Options For Treating Diabetic Neuropathy
How To Manage Heel Ulcers In Patients With Diabetes