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Foot and ankle radiology
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
The foot is imaged in an oblique axial plane through the long axis of the metatarsal bone. The coronal plane is imaged perpendicular to the oblique axial images and the sagittal plane is obtained to cover the medial and the lateral malleoli (Figure 22.1). Obtaining a mixture of T1- and T2-weighted images in at least two orthogonal planes are useful to evaluate the anatomy of the foot and ankle. Proton Density (PD) fat saturated sequences are useful for the assessment of the articular cartilage. The Short Tau Inversion Recovery (STIR) and T2-weighted fat saturated sequences accentuate fluid, which is seen in most pathologies such as oedema, tenosynovitis and joint effusion (Figure 22.1).
Diseases of the Peripheral Nerve and Mononeuropathies
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Diana Mnatsakanova, Charles K. Abrams
At the ankle: Residual symptoms from a sural nerve biopsy.Prolonged crossing of the ankles.Ganglion.Neuroma.Fifth metatarsal bone fracture.
Surgery
Published in Seema Khan, Get Through, 2020
For each case below, choose the SINGLE most likely cause from the list of options. Each option may be used once, more than once or not at all. A 50-year-old man presents with pain over the medial calcaneum and pain on dorsiflexion and eversion of the forefoot.A 60-year-old man complains of continual pain in his forefoot worse when walking. A radiograph shows widening and flattening of the second metatarsal head and degenerative changes in the metatarsophalangeal joint.A 50-year-old woman complains of shooting pains in her right foot when walking. There is tenderness in the third/fourth toe interspace.A 30-year-old soldier complains of pain in his foot when weight bearing. A radiograph shows no fracture. There is tenderness around the proximal fifth metatarsal bone.A 20-year-old man complains of pain over the lateral aspect of his right foot. A radiograph shows a transverse fracture of the basal shaft of the fifth metatarsal bone.
Preoperative Japanese Society for the Surgery of the Foot Lesser toe score and erythrocyte sedimentation rate influence wound healing following rheumatoid forefoot surgery
Published in Modern Rheumatology, 2021
Koji Ohta, Jun-ichi Fukushi, Satoshi Ikemura, Satoshi Kamura, Hisa-aki Miyahara, Yasuharu Nakashima
All the participants underwent elective forefoot surgery that was performed or supervised by three staff surgeons who had extensive experience in rheumatoid foot surgery. The choice of the surgical procedure performed was made by the surgeon, according to preference. The procedures conducted on the hallux included first metatarsal osteotomy and metatarsophalangeal joint arthrodesis [6]. The procedures conducted on the lesser toes included metatarsal-shortening osteotomy, resection arthroplasty, and varus corrective osteotomy of the fifth metatarsal bone (Coughlin’s osteotomy) (Figure 1 and Table 4) [6]. Resection arthroplasty of the lesser toes was performed using a plantar transverse incision, and the other procedures were performed using a dorsal longitudinal incision. A tourniquet was routinely used, and was deflated for at least 10 min when the time of application exceeded 120 min.
Modern management of diabetic foot osteomyelitis. The when, how and why of conservative approaches
Published in Expert Review of Anti-infective Therapy, 2018
Javier Aragón-Sánchez, Benjamin A Lipsky
Microorganisms that produce toxins may exacerbate inflammation, edema, and thereby intercompartmental pressure. Infection generally spreads through the foot via the tendons, which are poorly vascularized structures that may traverse multiple compartments. With a plantar ulcer under the first ray, contiguous osteomyelitis may spread through the medial compartment; osteomyelitis of the second to fourth ray may spread through the central compartment, while involvement of the fifth ray can move through the lateral compartment [14]. Sometimes, there is a spread of infection or fistulization from the plantar to the dorsal area; this finding makes clear that the intervening compartments are involved in the infection. Because infection typically spreads from a high-pressure to a lower pressure area, it can spread to the dorsal aspect of the foot after involving the bone in cases of plantar location of the ulcer. Figure 2 shows a patient with osteomyelitis of the base of the fifth metatarsal bone with infection that spread through the dorsal and plantar compartments of the foot, reaching an area close the medial malleolus.
Sacral stress fracture in an amateur golf player: a case report and literature review
Published in The Physician and Sportsmedicine, 2020
Ethem Kavukcu, Melahat Akdeniz
Stress fractures are overuse injuries in which recurrent strains lead to material fatigue and microarchitectural discontinuities as a result of repetitive use. They are most often seen in athletes in a wide age distribution range and, account for up to 20% of athletic injuries, more often in women and in the setting of track-and-field events [1]. It is different from the typical bone fracture caused by an acute event, such as a car crash or a fall. In the case of acute fractures, the bone experiences a very high force that causes the fracture. Stress fracture occurs due to forces that are much lower but happen repetitively for a long period of time, causing repetitive micro-traumas during prolonged strenuous activity. These type of fractures typically involve the bones of lower extremities such as, femur, tibia, fibula, metatarsal bones, or spine. The sacrum is an uncommon location for a stress fracture [2]. Therefore, sacral stress fractures are rare injuries among athletes. The few cases of sacral stress fractures that have been reported in the literature involve long-distancee runners [2,3], football [4], basketball [5], volleyball [6], tenis [7], badminton [8], hockey [9], and rugby [10] players. The largest case series of sacral stress fractures in the literature has been published by Vajapey et al. with five athletes [11]. Although sacral stress fractures are rare, they can be expected in high-impact sports. However, it is unexpected to be seen in low-impact sports like golf. The purpose of this paper is to report a sacral stress fracture in an amateur golf player. This is the first report in the medical literature of this kind of injury in golf.