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Forefoot disorders
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Weight-bearing anteroposterior, lateral and oblique radiographs of the feet. A CT scan (especially weight-bearing CT), SPECT scan, MRI scan and pedobarography would all be helpful in localising the pressure areas.
Pedobarographic, Clinic, and Radiologic Evaluation after Surgically Treated Lisfranc Injury
Published in Journal of Investigative Surgery, 2021
Engin Eceviz, Hüseyin Bilgehan Çevik, Orhan Öztürk, Tuğçe Özen, Tuğba Kuru Çolak, İlker Çolak, Mine Gülden Polat
The anatomic reconstruction of the joint congruence, the correct restoration of foot axis and foot columns are the most important predictors for good clinical outcome, therefore, most authors recommend operative treatment for tarsometatarsal (TMT) fracture dislocations [7–12]. In previous studies, the treatment outcomes of Lisfranc injuries have mostly been investigated using patient-reported outcome measures, physical examination, radiographic results, and pedobarographic analysis [12–14]. Of these assessments, pedobarographic analysis provides an objective measurement, guidance for patient-specific assessment, and specific diagnosis [15]. Therefore, the frequency of pedobarography use has increased in an effort to better understand foot and ankle pathologies [16]. Although pedobarographic studies analyzing Lisfranc injuries do exist, they are few and include a very low number of patients [11,16–18].
Diagnosis and conservative management of great toe pathologies: a review
Published in Postgraduate Medicine, 2021
Nicholas A. Andrews, Jessyca Ray, Aseel Dib, Whitt M. Harrelson, Ankit Khurana, Maninder Shah Singh, Ashish Shah
All patients should undergo weight-bearing 3-view radiographs of the foot, including anteroposterior, oblique, and lateral views to rule out foot and ankle pathologies. Patients presenting with concerns for turf toe or sesamoiditis should undergo sesamoid view of the great toe to allow for assessment of sesamoid position and avascular necrosis (AVN). Plain radiographs are used to evaluate for fractures, arthritis, and other structural abnormalities. If there is a possibility of a stress fracture that is not demonstrated on standard radiographs, then a CT or MRI may be warranted. If the plain x-ray is unremarkable and there is suspicion for soft tissue injury, then an ultrasound or an MRI is the next step in diagnostic evaluation [11]. Scintigraphy, or nuclear bone scan, has historically been a useful inexpensive tool for the detection of suspected stress fractures or osteomyelitis [12]. However, modern MRI is now the modality of choice for detection of these pathologies except in instances of limited MRI access, cost concerns, or patients with suspected stress fractures in multiple extremities [12]. Pedobarography is a method of dynamic imaging that allows for assessment of the loads placed on various locations of the foot during ambulation. This functional assessment can be extremely helpful in designing personalized orthotics for the treatment of functional overload conditions such as metatarsalgia [13]. Additionally, foot and ankle specialists are beginning to use 3D printed individualized foot models to better assess pathology and plan potential interventions [14,15]. Ultimately, the choice of imaging modalities should be guided by clinical suspicion beginning with 3-view plain radiographs and progressing to more complicated modalities like CT or MRI.
The prevalence and risk factors for foot pressure ulcers in ambulatory pediatric patients with spina bifida
Published in Disability and Rehabilitation, 2021
Susan Rethlefsen, Nicole Mueske, Tishya Wren, Rajan Murgai, Melissa Bent
Foot pressure ulcers are common in ambulatory children with spina bifida and occur with an overall prevalence of 8.8% with highest prevalence between the ages of 11–15 years old. The results suggest the most significant factors associated with development of pressure ulcers are age between 11–15 years, varus or valgus foot deformities in standing and non-weight bearing, and use of braces. Rigidity of foot deformity did not predict occurrence of foot pressure ulcers in our patients. Further research is warranted with a larger sample and inclusion of additional variables such as location of high pressure contact areas through pedobarography.