The ankle and foot
Ashley W. Blom, David Warwick, Michael R. Whitehouse in Apley and Solomon’s System of Orthopaedics and Trauma, 2017
In pes cavus the arch is higher than normal, and often there is also clawing of the toes. The close resemblance to deformities seen in neurological disorders where the intrinsic muscles are weak or paralyzed suggests that all forms of pes cavus are due to some type of muscle imbalance. There are rare congenital causes, such as arthrogryposis, but in the majority of cases pes cavus results from an acquired neuromuscular disorder (see Box 21.1). A specific abnormality can often be identified; hereditary motor and sensory neuropathies and spinal cord abnormalities (tethered cord syndrome, diastematomyelia) are the commonest in Western countries but poliomyelitis is the most common cause worldwide. Occasionally the deformity follows trauma such as burns or a compartment syndrome resulting in Volkmann’s contracture of the muscles in the sole.
Rheumatology
Fazal-I-Akbar Danish in Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Pain or limitation of movement of the foot:1 Problem with the big toe (hallux valgus; hallux rigidus).2 Problem with other toes (hammer toes; claw toes).3 Problem with foot arches (pes planus; pes cavus).4 Problem with the metatarsals (metatarsalgia; Morton’s metatarsalgia d/t interdigital neuroma; march fracture – 2nd or 3rd metatarsal involved).5 Heel pain (d/t tear of calcaneal tendon; post calcaneal bursitis; arthritis of subtalar joint; plantar fasciitis).
Diagnostic algorithms for painful peripheral neuropathy
Harald Breivik, William I Campbell, Michael K Nicholas in Clinical Pain Management, 2008
Neurological examination will be aimed at trying to define the neuroanatomical site of any lesion and the types of peripheral nerve fiber involved. Observation should be made of muscle bulk (in length-dependent neuropathies wasting is usually first seen in the extensor digitorum brevis muscle in the feet and the first dorsal interosseus in the hands). Fasciculation indicates muscle denervation. Pes cavus is a sign of a long-standing neuropathy which is often but not exclusively hereditary. Look/feel for any evidence of thickened nerves (the superficial radial, ulnar, and posterior auricular are particularly amenable to palpation). These are seen in some inflammatory and demyelinating neuropathies, as well as in leprosy.
Acute effect of taping on plantar pressure characteristics in athletes with exercise-induced leg pain: a description and comparison of groups
Published in The Physician and Sportsmedicine, 2019
JaeMyoung Park, Taegyu Kim
Injuries to the lower extremities are common in various elite athletes, and it is important to control risk factors for preventing injuries [54]. In this study, the taping applied to the foot and ankle joint for elite athletes with or without exercise-induced leg pain for restricting the foot pronation that is considered as a potential lower leg overuse injury risk factor [5]. However, only the contact area, maximum force, and peak pressure were selected among plantar pressure characteristics in this study because they are highly correlated [14]. The pressure-time integral was known to provide information on the load distribution over time and the instant of peak pressure could demonstrate the time at which peak pressure occurs [22]. Also, Hillstrom et al. [11] stated that there was the difference in the trajectory of the center of pressure between the pes planus (flat foot) and the pes cavus (high-arched foot). Therefore, further studies should include these parameters and the trajectory of the center of pressure during various sports activities, in order to provide more information on the prevention of overuse injuries, such as exercise-induced leg pain, in the lower extremities.
Innovative treatment for pes cavovarus: a pilot study of 13 children
Published in Acta Orthopaedica, 2018
Ignacio Sanpera Jr, Guillem Frontera-Juan, Julia Sanpera-Iglesias, Laura Corominas-Frances
In summary, we believe that this technique may be useful for the treatment of pes cavovarus during childhood, although its use should be limited to cavovarus associated with weakness or the idiopathic form. The technique follows the principles laid down by Mosca (2001) for the treatment of pes cavus. First, the segmental deformities should be corrected while preserving joint motion (1st metatarsal hemiepiphysiodesis corrects the fall of the metatarsal). Next, the remaining muscle forces should be balanced out (achieved by plantar fascia release). Third, this leaves open the possibility of reasonable treatment options because the foot remains almost untouched.
Genotype-phenotype correlations of KIF5A stalk domain variants
Published in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2021
Eva M. J. de Boer, Wouter van Rheenen, H. Stephan Goedee, Erik-Jan Kamsteeg, Eva H. Brilstra, Jan H. Veldink, Leonard H. van Den Berg, Michael A. van Es
Neurological examination showed normal function of cranial nerves and no pseudobulbar reflexes. There was no weakness or sensory deficits in the upper limbs. However, reflexes in the arms were pathologically brisk bilaterally including positive Hoffman-Trömner reflexes. Examination of the lower limbs showed subtle generalized atrophy of the entire left leg and bilateral pes cavus with hammer toes. Both legs were hypertonic, with pathologically brisk reflexes, sustained ankle clonus and positive Babinski sign bilaterally. He also had distal dysesthesia and hyperalgesia with normal vibration and position sense.
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