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Examination of Foot and Ankle in a Child
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Nirmal Raj Gopinathan, Mandeep Singh Dhillon, Pratik M. Rathod
The anatomical alignment of the foot and toes and any abnormal alignment of toes or overriding is noted (Table 11.3, toe deformities). For example, in juvenile hallux valgus (Figure 11.11), the big toe deviates outwards away from the midline at the metatarsophalangeal joint. Also, in longstanding disorders, there may be continuous footwear irritation over the prominent distal medial metatarsal aspect leading to callosity formation (bunion).
Leg, foot and nail disease in the elderly
Published in Robert A. Norman, Geriatric Dermatology, 2020
M. Alam, R. K. Scher, P. I. Schneiderman
Hyperkeratotic lesions (Figures 5–8) occur focally and diffusely over bony prominences and areas of increased friction54. Hyperkeratosis is a normal reaction of the skin to internally or externally applied pressure55 and can present as a callosity, callus, or corn56. According to one definition, a callosity is a plaque caused by repeated friction or pressure; a corn is a sharply demarcated callosity over a bony prominence, especially of the hands or feet, that is painful; and a callus is a broad, diffuse hyperkeratosis under the metatarsal heads (Figures 5–8)57. Soft corns between the fourth and fifth toes may be extremely painful and accompanied by maceration and cellulitis58,59. The soles of the feet in the elderly are vulnerable owing to fat pad atrophy, asymmetric pressure load and impaired vascular supply60,61. Hyperkeratoses on the sole can erode to form ulcers, with up to 30% of leg ulcers in the elderly occurring on the foot or sole. In patients with vascular or neurologic impairment, hyperkeratoses should be debrided to see if they conceal a deep ulcer or osseous involvement54. For women especially, hyperkeratotic and other foot problems are frequently related to a lifetime of wearing shoes that are too small and narrow4,62.
The ankle and foot
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
The sole is particularly at risk of penetration by small foreign bodies (usually a thorn, a splinter or a piece of glass), which may give rise to a painful lump resembling a wart or callus. This diagnosis should always be considered if the ‘callosity’ is situated in a non-pressure area. X-rays may help to detect the foreign body.
Occupational ergonomic assessment of hand pain symptoms among Bagh hand block print artisans of the handicraft textile industry in Madhya Pradesh, India
Published in International Journal of Occupational Safety and Ergonomics, 2022
Rajat Kamble, Avinash Sahu, Sangeeta Pandit
Table 1 presents the study subjects’ socio-demographic data and the presence of noticeable CEMT among the artisans categorizing the artisans based on the age groups, experience levels and type of CEMT. Of all the study subjects, about 20% of them were young, and most of the study subjects were mid-aged (28.6%). Very few subjects had beginner-level experience (22.9%), while most of them were proficient and advanced beginner-level experience. Among the study subjects (Table 1), 15.7% had developed lichenification on the palm’s abductor digiti minimi region. A total of 57.1% showed noticeable callosity formation and lichenification, and 27% had hard skin along with lichenification. Figure 3(a)–(c) represents the different types of skin manifestation.
Relationship of callosities of the forefoot with foot deformity, Health Assessment Questionnaire Disability Index, and joint damage score in patients with rheumatoid arthritis
Published in Modern Rheumatology, 2020
Takeshi Mochizuki, Koichiro Yano, Katsunori Ikari, Ryo Hiroshima, Mina Ishibashi, Ken Okazaki
This study investigated the clinical course and background variables of patients with RA who fulfilled the American College of Rheumatology (ACR) classification criteria (1987) and/or the ACR/European League Against Rheumatism (EULAR) criteria [13,14]. A total of 202 patients (404 feet) were enrolled from December 2016 to September 2017 in the outpatient clinic. Patients were excluded if they had undergone arthroplasty of the feet or had heart failure, stroke, and/or dementia. We looked at the soles of the patients and examined callosities. Clinical data were measured on the day the plantar callosities of the forefoot were examined. We defined callosity as a well-circumscribed hyperkeratotic lesion. Clinical data included age, sex, disease duration, pain visual analog scale (VAS), C-reactive protein (CRP), DAS28-erythrocyte sedimentation rate (ESR), HAQ-DI, and TSS. The foot deformities included hallux valgus angle (HVA), first metatarsal and second metatarsal angle (M1M2), first metatarsal and fifth metatarsal angle (M1M5), calcaneal pitch angle (CPA), and the severity of destruction in the MTP joints as seen on X-rays in the weight-bearing position. The severity of destruction in the MTP joints was classified according to Larsen grade (LG) [15]. The foot deformities and the TSS were measured by authors T.M. and M.I.
Changes in radiographic findings and plantar pressure distribution following forefoot reconstructive surgery for patients with rheumatoid arthritis
Published in Modern Rheumatology, 2020
Hyunho Lee, Hajime Ishikawa, Tatsuaki Shibuya, Chinatsu Takai, Yumi Nomura, Daisuke Kobayashi, Asami Abe, Hiroshi Otani, Satoshi Ito, Kiyoshi Nakazono, Keinosuke Ryu, Takao Ishii, Shu Saito, Kaoru Abe, Akira Murasawa
This study was performed on RA patients who underwent Swanson implant arthroplasty for the 1st MTP combined with shortening oblique osteotomy at the 2nd through 5th metatarsal necks at our hospital from April 2012 to March 2016. Patients who had history of previous foot surgery and severe hip, knee or ankle joint destruction equal to or higher than Larsen grade III were excluded, because it was thought that malalignment of the lower limbs affected plantar pressure in patients with severe joint destruction in the hip, knee, and ankle joints. Surgical reconstruction was indicated to the patients with persistent painful callosity in the forefoot as an alternative to intensive foot care, which included shaving of the callosity and applying adequate footwear. There were 55 feet in 43 patients, consisting of 51 feet in 39 female patients and four feet in four male patients (group Sw). All patients in the study underwent shortening oblique osteotomy at the 2nd through 5th metatarsal neck [6]. In addition, the postoperative results in group Sw were compared with the values obtained from two control groups: group NS, consisting of 75 feet in RA patients without scheduled forefoot surgery, and group HC, consisting of 24 feet with no callosities in healthy female control subjects. The patients in group NS were recruited from RA patients who hospitalized for the purpose of upper extremity surgery or disease control and had no callosities, no dislocations of the MTPs and no severe hip, knee or ankle joint destruction equal to or higher than Larsen grade III. Additionally, RA patients with a hallux valgus angle (HVA) of 0–20° were chosen for group NS. This study was approved by the ethics committee of our institution.