Lateral plantar nerve injury following steroid injection for plantar fasciitis.
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A 41 year old man presented with pain and numbness affecting the lateral aspect of his foot after a steroid injection for plantar fasciitis. Examination confirmed numbness and motor impairment of the lateral plantar nerve. The findings were confirmed by electromyographic studies. The anatomy of the lateral plantar nerve and correct technique for injection to treat plantar fasciitis are discussed. (+info)
Extrarenal malignant rhabdoid tumour of the heel--a case report.
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Malignant rhabdoid tumour is a rare soft-tissue neoplasm that occurs in children and young adults. Cases have involved numerous extrarenal sites, including the thymus, liver, paravertebral region, central nervous system, heart, prostate, pelvis, chest wall, extremities, as well as soft tissues. Given their highly aggressive nature, early diagnosis of rhabdoid tumours is essential; indeed, survival times after initial presentation are typically in the range of months rather than years. The low incidence of rhabdoid tumours and confusion between this type of tumour and other tumours has precluded the collection of adequate data on its clinical presentation and there is no specific therapeutic protocol. Owing to the rarity of this condition and the difficulties encountered in its diagnosis and treatment, we report the case of a malignant tumour with rhabdoid-like features in the foot that confirms the local aggressiveness and the high metastatic potential of this type of tumour. (+info)
Chondroma of the subcutaneous bursa of the Achilles tendon.
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A 46-year-old female presented a six-month history of posterior heel pain. Clinical and radiographical examination revealed a nodular calcified mass into the subcutaneous tissue of the Achilles tendon bursa. Following excision, histopathology showed an extraskeletal soft-tissue chondroma. Follow up at 24 months showed no recurrence. To our knowledge, this is the first description of a soft tissue chondroma at this site: some soft tissue tumors develop at unusual anatomic location. (+info)
Heel pain: diagnosis and treatment, step by step.
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The differential diagnosis of heel pain is broad and can be overwhelming if a systematic approach is not used. Focused questions and physical examination can help identify heel pain as Achilles tendinopathy or plantar fasciitis, or as due to a less common cause such as gout, spondyloarthropathy, or hypercholesterolemia. (+info)
The application of Aquaplast Thermoplastic as a bolus material in the radiotherapy of a patient with classic Kaposi's sarcoma at the lower extremity.
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BACKGROUND: The classic Kaposi's sarcoma (KS) patients usually present with progressive skin lesions over the lower extremities, following an indolent course. Although radiotherapy is an effective treatment for KS, radiation over these lesions is not without difficulty. The intrinsic difficulty resides in how a homogenous radiation dose over superficial lesions involving large areas and irregular surface is properly delivered. Several bolus techniques have thus been invented. MATERIALS AND METHODS: The Aquaplast RT Thermoplastic is a new type of bolus material that can be easily molded and conformed to the curvature of skin, with the equivalence to soft tissue in radiation interaction. RESULTS: This material was applied as the bolus for the irradiation of a classic KS patient, whose disease involved multiple skin areas over the right heel and ankle. Large parallel-opposed irradiation fields delivered by 60Co were used. Computed tomography demonstrated a close conformity of the bolus built-up by Aquaplast RT Thermoplastic to the surface of the ankle and foot. A dosimetry measurement further confirmed an adequate and homogenous distribution of desired dose around the lesions of the lower extremity. After a total dose of 39 Gy, divided in 13 fractions, the lesions remitted completely. CONCLUSION: Our data suggest that the use of Aquaplast RT Thermoplastic as a bolus material is helpful in delivering adequate dose to skin lesions of the lower extremities. (+info)
Location of plantar ulcerations in diabetic patients referred to a Department of Veterans Affairs podiatry clinic.
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This study described the location of foot ulcerations via a retrospective chart review of diabetic patients in a Department of Veterans Affairs podiatry clinic and correlated location of ulceration with specific medical parameters. The heel was a site of ulceration in 11% of the patients. By multiple logistic regression, patients with diminished vascular function were more than five times more likely to have heel ulceration than patients with adequate vascular status. The findings suggest that heel ulcerations are more common than originally thought and are associated with diminished vascular status. Further work is necessary for reducing plantar heel pressure in individuals who are not presently candidates for vascular interventions. (+info)
Microchambers and macrochambers in heel pads: are they functionally different?
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The heel pad consists of a superficial microchamber layer and a deep macrochamber layer. This study highlights the different biomechanical behaviors between the microchamber and macrochamber layers using ultrasonography. The heel pad in each left foot of six healthy volunteers aged approximately 25 yr old was measured with a device consisting of a 10-MHz linear-array ultrasound transducer and a load cell. The testing heels were loaded on the ultrasound transducer with a loading velocity of approximately 0.5 cm/s and were withdrawn when the specified maximum stress (158 kPa) was reached. Unloaded tissue thickness, end-loaded thickness, deformation proportion, average deformation, and rebound rates and elastic modulus of the microchamber and macrochamber layers were assessed. The unloaded thickness of the microchamber layer was approximately 30% of the macrochamber layer. The microchamber layer also had significantly less unloaded thickness, end-loaded thickness, mean deformation rate, mean rebound rate, and deformation proportion than the macrochamber layer. A significant difference between the unloaded and end-loaded thickness in the macrochamber layer was observed. The average soft tissue deformation rate was significantly different from the rebound rate in the microchamber layer. A similar trend was detected in the macrochamber layer. The elastic modulus of the microchamber layer was 450 kPa (SD 240), which was nearly 10 times of that in the macrochamber layer. In conclusion, ultrasound can identify the heterogeneous tissue properties of the heel pad. The macrochamber layer responds to loading with large deformation, and the microchamber layer has a high degree of tissue stiffness. (+info)
Effect of suckling on the peripheral sensitivity of full-term newborn infants.
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BACKGROUND: Sucking may reduce the manifestations of pain in newborn infants. OBJECTIVE: To examine the effect of suckling on the threshold for peripheral somatosensory responses. SUBJECTS AND METHODS: Graded Von Frey filaments were applied to the heel to initiate peripheral somatosensory responses (withdrawal reflex and gross body movements) in term infants. RESULTS: Dummy sucking increases the somatosensory threshold, but breast feeding had a more marked effect, increasing the threshold of the flexion withdrawal reflex (p+info)