CommonFootPathologiesObjec4ves

•  Iden4fycommondeformi4esandcondi4onsrela4ngtothelowerextremity.

•  Discussthesignificanceandrela4onshipofthepathologyandtheeffectsonselec4ngfootwear.

•  ComparethepathologywhenitrelatestosomeonewithandwithoutDiabetesMellitus.

Condi&on:Onychomycosis(NailFungus)Acommondiseaseofthenailsinwhichthenailsbecomethickenedanddiscolored.Astheinfec4onprogresses,thenailcanbecomebriHleandbreakoff.Cause:Agingisthemostcommonriskfactorduetodiminishedbloodcircula4on.Perspiringheavily,humid/moistenvironment,wearingsocksandshoesthathinderven4la4onanddonotabsorbperspira4on,athlete’sfoot,minorskinornailinjury.Treatment:Oralan4fungalmedica4ons;longtermtopical

Condi&on:Edema(Swelling)Anabnormalaccumula4onoffluidtrappedbeneaththeskinverycommonlyfoundinthelowerextremi4essuchasthefeetandlegs;venousinsufficiencyCause:Medica4ons;liverorkidneydisease;heartfailure;venousinsufficiencies;pregnancyTreatment:Medica4ons;Elevatefeetaboveheartlevel;compressionhosiery;IntermiHentpneuma4ccompression

Condi&on:LymphedemaAbnormalcollec4onofhigh-proteinfluidjustbeneaththeskin;developswhenlymphvesselsaredamagedorlymphnodesareremoved(secondarylymphedema)butcanalsobepresentwhenlympha4cvesselsaremissingorimpairedduetoahereditarycondi4on(primarylymphedema)Cause:Hereditary,surgery,infec4on,cancerTreatment:Exercise,massagetherapy,legwraps(4ghtestattoes),compressionhosiery,pneuma4ccompression(Nottobeconfusedwithvenousinsufficiencyedemawithdifferingtreatment)

Condi&on:CharcotArthropathyAprogressivemusculoskeletalcondi4oncharacterizedbyjointdisloca4on,fracturesanddeformi4es.Itresultsinprogressivedestruc4onofboneandsoU4ssueofweight-bearingjoints,mostcommonlyinthefootandankle.Itismostcommonlysecondarytodiabetes.Cause:Lossofsensa4onandpropriocep4onleadstorepe44vetraumathejoint;damagegoesunno4cedbytheneuropathicpa4ent,andtheresultantinflammatoryresorp4onoftrauma4zedbonerendersthatregionweakandsuscep4bletofurthertraumaTreatment:Pressurerelief(off-loading)andimmobiliza4onwithtotalcontactcas4ng(TCC)arecri4caltohelpingwardofffurtherjointdestruc4on;walkingbraces

Condi&on:PlantarFascii&s“FirstStepPain”Inflamma4onoftheplantarfascia(Commoncauseofheelpain)Cause:Overuse-longperiodofstanding,increaseinexercise,obesity,improperfootwearPreven&on/Treatment:Archsupports;an4-inflammatorymedica4ons;cor4soneinjec4ons;stretching,nightsplints

Condi&on:PosteriorTibialTendini&s/Dysfunc&on(AdultAcquiredFlaJoot)Inflamma4on/Stretching/Tearingoftheposterior4bialtendonandinabilitytosupportorstabilizethearchofthefootCause:Injury;Underlyingbiomechanicaldefect;Overusefromwalking,running,hikingTreatment:Rest,Ice,an4-inflammatorymedica4ons,ortho4cs,bracing,surgeryinsomeinstances,physicaltherapy

Condi&on:Stroke(DropFoot)Braincellsaredeprivedofoxygen—theresultcanbememoryandmusclecontrolloss--difficultyliUingthefootup(dorsiflex)Cause:Morelikelytoaffectpeopleiftheyareoverweight,aged55orolder,familyhistory,lackofexercise,drinkheavily,smokeoruseillicitdrugs.Footdropcanalsobecausedbynerveorspineinjuries.Treatment:Aspirin,surgery,rehab,shoemodifica4on(toeskater),bracing,build-uponcontralateralshoe

Condi&on:LimbLengthDiscrepancyUnequalleglengthsduetoanumberoffactorsincludinghipreplacement,scoliosis,orhyperprona4oncondi4ons.Cause:Hip/Kneesurgery/fracture,scoliosis,hyperprona4on,congenitalTreatment:HeelandsoleliU

Condi&on:DeepVeinThrombosis(DVT)Forma4onofabloodclotinadeepveinandcausespain,swellingandredness;PulmonaryEmbolism(PE)isadetachmentofaclotwhichmayresultindeathifitreachesthelungCause:3Factors:Virchow'striad—venousstasis(slowblood),hypercoagulability(clodng),andchangesintheendothelialbloodvessellining(suchasphysicaldamageorendothelialac4va4on)Treatment/Preven&on:Frequentwalking,calfexercises,an4coagulants,aspirin,graduatedcompressionstockings,andintermiHentpneuma4ccompression.

Condi&on:Morton’sToeAcondi4oninwhichthefirstrayisshorterthannormal.Some4mesresultsincallousesunderthe2ndand3rdmetatarsalsCause:HereditaryTreatment:Properlengthshoes,footorthoses

Condi&on:IngrownNailsOUenpainfulcondi4oninwhichthenailgrowssothatitcutsintooneorbothsidesofthenailbed.Possibleinfec4onifleUuntreated.Cause:Improperlyfitshoes,poornailcare,trauma,hereditaryTreatment:Soakinginwaterandsalt,surgicaltreatment,properlyfidngshoes

Condi&on:PlantarWarts(Veruca)Causedbyavirus(humanpappillomavirus-HPV);thevirusaHackscompromisedskinthroughdirectcontact,enteringthrough4nycutsandabrasionsCause:ViralPreven&on/Treatment:Changingsocks/shoesregularly;wearfootwearincommunalshowers;medica4onsandsurgery

Condi&on:GangreneBody4ssuedies;canalsooccurinsidethebodyCause:Diabetes,PAD,Atherosclerosis,smoking,trauma,obesity,mayoccuraUeraninfec4onTreatment:Debridement,surgery/amputa4on,maggottherapy,hyperbaricoxygentherapy

Condi&on:HalluxLimitus/RigidusLimitus:Limita4onofmo4onatthefirstMTPjointthatresultsinafunc4onalimpairment.Rigidus:totallackofmo4onofthefirstMTPJ.Lessthan20°dorsiflexionisapproximatelythedegreeatwhichthejointtranslatesfromlimitustorigidus.Painandswellingsome4mesresultsCause:Previoustraumaand/orwearandtearoffirstMTPJTreatment:Footortho4cs,RigidMorton’sextension/footplate,shoemodifica4ons—rigidrockerboHom,medica4ons(an4-inflammatorydrugs),and/orphysicaltherapy

Condi&on:EquinusLimiteddorsiflexionofthefoot;Compensatebytoe-walking.Cause:TightnessintheAchillestendonorcalfmuscles;congenital;acquiredthroughsitua4onslimi4ngtheupwardmovementforperiodsof4me,suchascasts,crutchesorconstantuseofhighheels;Diabetescanalsocause4ghtnessoftheAchillestendonTreatment:Calfstretching,nightsplints,heelliUs,andarchsupportsorortho4cs

Condi&on:ChronicAnkleInstabilityWeaknessinankle;chronicanklesprains.Canbefunc4onalinstabilityormechanicalinstability.Cause:Peronealtendonweakness,mul4pleanklesprains,Treatment:Suppor4veShoes,FootOrthoses;Bracing;PhysicalTherapy(Stretching/Strengthening);Surgery

Addi&onalTerms:Sensate-withfeelingInsensate-withoutfeelingIschemia-restric4oninbloodsupply,generallyduetofactorsinthebloodvesselsDebridement-isthemedicalremovalofapa4ent'sdead,damaged,orinfected4ssuetoimprovethehealingpoten4aloftheremaininghealthy4ssue.Acute-shortonset;rapidcourseChronic-persistentandlas4ngmedicalcondi4on

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