There are a few deformities that can present in children that deal with the lower limbs. One of those is Rickets. This is a softening of bones in children due to either a deficiency or impaired metabolism of vitamin D, phosphorus, or calcium. The most common cause is vitamin D deficiency. Vitamin D is needed for your body to properly absorb calcium from your gut. We get vitamin D when the sunlight hits our skin and produces it. While this disease can occur in adults, the majority of cases are children suffering from very severe malnutrition. When this occurs in adults it is known as osteomalacia.
A toddler with rickets will have legs that are bowed outward, while older children will present with knock-knees. There is also bone pain or tenderness, dental problems, muscle weakness and a tendency for fractures. Lab results could show hypocalcemia, which means low levels of calcium in the blood. The symptoms of associated pain and fractures are what help your podiatrist set apart this disease from a structural deformity like genu valgum, or tibial varum, which is just the position your leg bones have grown from birth. Blood work also helps confirm the diagnosis.
More cases have been reported in Britain lately due to the inability of children to make vitamin D. But these kids weren’t starved or poor. The sunlight was not reaching their skin due to the persistent use of sunblock. This wasn’t allowing any sunlight to reach their skin, or they were spending too much time indoors with the TV, computer, etc. Treatment for rickets depends on the cause. Treatment for nutritional rickets includes vitamin D supplementation and a diet high in calcium. The earlier these children are diagnosed, the better. If the disease becomes too advanced, the bony deformities can be permanent. For questions about this or any other childhood foot deformity, come by and see Dr.Grimm or Dr.Pattison.
Thursday, February 17, 2011
Tuesday, February 15, 2011
Flood Zones
For this week’s blog we look at a natural disaster less-commonly found in Texas, floods. These are still worth mentioning in light of the rain associated with the upcoming spring. This not only applies to massive flooding, but walking out to the patio or driveway where there’s standing water. Many times people in high water will walk bare foot to avoid their shoes from becoming soaked. At best, some may wear thong flip flops. This increases your risk of getting an infection or even a disease.
During a flood, damage and debris can wash as far as the water will take it. So while you may be walking on what you think is your clean driveway, there could be rusty nails from a construction site up the road. And it doesn’t just have to be a puncture wound either. Any small cuts or abrasions that were already on your legs and feet are exposed to the contaminated water. This can lead to infections such as trench foot, tinea (athlete’s foot), cellulitis, or osteomyelitis. Recently, Kevin Rudd, the former prime minister of Australia, was admitted to the hospital for such a thing. He contracted an infection while helping flood victims there.
If you think you may have an infected wound, be sure to wash it with cool water. Use soap and a clean washcloth to clean the skin around the wound. Be cautious of getting soap into the wound as this can irritate it. An antibiotic ointment can be applied to help fight infection. For a more serious wound, call your podiatrist to get it checked out. If it’s a deep wound, then it may require a few stiches. If the area becomes tender and inflamed, leaks any creamy fluid, or you start to run a temperature, call your podiatrist immediately as this could lead to more serious conditions. Your podiatrist will perform a detailed inspection and determine the best course of treatment on a case-by-case basis. For all those nicks, cuts, and foot bruises, come by and see the physicians at Foot Associates of Central Texas.
During a flood, damage and debris can wash as far as the water will take it. So while you may be walking on what you think is your clean driveway, there could be rusty nails from a construction site up the road. And it doesn’t just have to be a puncture wound either. Any small cuts or abrasions that were already on your legs and feet are exposed to the contaminated water. This can lead to infections such as trench foot, tinea (athlete’s foot), cellulitis, or osteomyelitis. Recently, Kevin Rudd, the former prime minister of Australia, was admitted to the hospital for such a thing. He contracted an infection while helping flood victims there.
If you think you may have an infected wound, be sure to wash it with cool water. Use soap and a clean washcloth to clean the skin around the wound. Be cautious of getting soap into the wound as this can irritate it. An antibiotic ointment can be applied to help fight infection. For a more serious wound, call your podiatrist to get it checked out. If it’s a deep wound, then it may require a few stiches. If the area becomes tender and inflamed, leaks any creamy fluid, or you start to run a temperature, call your podiatrist immediately as this could lead to more serious conditions. Your podiatrist will perform a detailed inspection and determine the best course of treatment on a case-by-case basis. For all those nicks, cuts, and foot bruises, come by and see the physicians at Foot Associates of Central Texas.
Friday, February 11, 2011
Complex Regional Pain Syndrome
Complex regional pain syndrome (CRPS), formerly known as Reflex Sympathetic Dystrophy Syndrome (RSDS), is a very debilitating disorder that podiatrists sometimes see. This disorder begins after a nerve injury. This injury can leave the nerves in a hypersensitive and painful state. This causes patients to have “out of proportion” pain. This means that an action or stimulus that would barely hurt a person without this condition causes excruciating pain to the person with CRPS.
The exact cause of CRPS is not completely understood. It is suspected that damage to the nerves causes problems in controlling blood vessels and sweat glands. These damaged nerves lose the ability to control temperature, blood flow, and sensation to the affected area. CRPS is more common between the ages of 40-60.
There are 3 stages to CRPS but they don’t necessarily represent an ordered progression. You could be in one stage indefinitely or start out at stage 2 or 3 without going through 1. Symptoms range from severe burning, aching to the lightest touch. The skin could become dry and thin. Pain may move further up the limb. This could progress to swelling, changes in bone on an x-ray, stiff muscles and joints. And severe forms could include a painful entire limb, muscle wasting, and contractions involving muscles of the limb.
Treatment is tough for this condition. Your podiatrist commonly will take a team approach, possibly working with physical therapy and pain management specialists. Medications could include strong pain killers, steroids, and medications for blood pressure. Physical therapy can work with applications of hot and cold for pain relief. For the pain, nerve blocks could be utilized. For more severe cases, surgery would be pursued to cut the affected nerves. For help with this serious condition, see Dr.Grimm or Dr.Pattison to start building your treatment team.
The exact cause of CRPS is not completely understood. It is suspected that damage to the nerves causes problems in controlling blood vessels and sweat glands. These damaged nerves lose the ability to control temperature, blood flow, and sensation to the affected area. CRPS is more common between the ages of 40-60.
There are 3 stages to CRPS but they don’t necessarily represent an ordered progression. You could be in one stage indefinitely or start out at stage 2 or 3 without going through 1. Symptoms range from severe burning, aching to the lightest touch. The skin could become dry and thin. Pain may move further up the limb. This could progress to swelling, changes in bone on an x-ray, stiff muscles and joints. And severe forms could include a painful entire limb, muscle wasting, and contractions involving muscles of the limb.
Treatment is tough for this condition. Your podiatrist commonly will take a team approach, possibly working with physical therapy and pain management specialists. Medications could include strong pain killers, steroids, and medications for blood pressure. Physical therapy can work with applications of hot and cold for pain relief. For the pain, nerve blocks could be utilized. For more severe cases, surgery would be pursued to cut the affected nerves. For help with this serious condition, see Dr.Grimm or Dr.Pattison to start building your treatment team.
Monday, February 7, 2011
Pedicures
Pedicures are nothing new. People have been manicuring their nails for thousands of years, going back to the Ancient Egyptians and the Ming Dynasty. What has changed is the number of nail salons. From 2000-2010 the pedicure industry boomed from 50,000 locations nationwide, to 100,000. So what should you look out for when getting your nails treated at one of these establishments? It has been reported that 1/100 customers develop an infection from a dirty whirlpool. The germs from these can lead to more serious complications of the foot. Here are some tips to minimize the risk:
1. Are you healthy enough for a pedicure?
-Diabetes? Poor circulation? Neuropathy? Skin problems? These could increase your risk of infection so if you’re not sure, get your feet looked at by a podiatrist to be on the safe side.
2. Give your ankles and feet a look over before the pedicure.
-Any open wounds or cuts can increase the risk of infection. Also, ladies don’t shave the day before your pedicure as this can cause breaks in the skin too small for the eye, but just the right size for bacteria.
3. Inquire your pedicurist.
-Ask if they are licensed. And ask about their instruments. Do they autoclave them (a fancy sterilization machine). Or do they use hospital grade disinfectant solution? Also notice how they clean their footbath for each customer. These baths are the big source of germ breeding and should be disinfected properly
4. How’s the place look?
-Make sure your salon looks clean and presentable. This can tell you about how the business keeps their environment clean to avoid germ build up. There shouldn’t be nail clippings on the floor or tools lying out.
5. Pain?
-A pedicure should never hurt. If it does, one of two things is wrong. They either messed up or your foot has a problem that could require medical attention.
Pedicures are a great way to keep your feet maintained and inspected frequently. These are just a few tips to keep you safe so your feet can continue to be rewarded. If you have any issues from a pedicure or anything else, come by and see Dr.Grimm and Dr.Pattison at Foot Associates of Central Texas.
1. Are you healthy enough for a pedicure?
-Diabetes? Poor circulation? Neuropathy? Skin problems? These could increase your risk of infection so if you’re not sure, get your feet looked at by a podiatrist to be on the safe side.
2. Give your ankles and feet a look over before the pedicure.
-Any open wounds or cuts can increase the risk of infection. Also, ladies don’t shave the day before your pedicure as this can cause breaks in the skin too small for the eye, but just the right size for bacteria.
3. Inquire your pedicurist.
-Ask if they are licensed. And ask about their instruments. Do they autoclave them (a fancy sterilization machine). Or do they use hospital grade disinfectant solution? Also notice how they clean their footbath for each customer. These baths are the big source of germ breeding and should be disinfected properly
4. How’s the place look?
-Make sure your salon looks clean and presentable. This can tell you about how the business keeps their environment clean to avoid germ build up. There shouldn’t be nail clippings on the floor or tools lying out.
5. Pain?
-A pedicure should never hurt. If it does, one of two things is wrong. They either messed up or your foot has a problem that could require medical attention.
Pedicures are a great way to keep your feet maintained and inspected frequently. These are just a few tips to keep you safe so your feet can continue to be rewarded. If you have any issues from a pedicure or anything else, come by and see Dr.Grimm and Dr.Pattison at Foot Associates of Central Texas.
Wednesday, February 2, 2011
Super Bowl Sunday
It might as well be a holiday. Super Bowl Sunday brings everyone together in front of their favorite TV. As we look forward to watching the battle between the Steelers and Packers, we’ll also be looking for the multi-million dollar commercial ads that rarely disappoint. With Super Bowl Sunday coming up, there’s one player who won’t be there, Tom Brady. The Patriots QB has been in the news lately for having foot surgery after their loss to the NY Jets. So what happened to him?
Tom Brady suffered a chronic stress fracture of the navicular bone. This is a small bone on the inside of your foot that gets a considerable amount of force put through it. Brady was said to have played through this injury for a major part of the season. Stress fractures are a little different than normal breaks. Stress fractures occur from a long repetitive stress on the bone, possibly caused by muscle pulling on its bony attachments. Normal fractures are usually a specific instance of trauma. The concern with a stress fracture in the navicular bone is that your weight transfers through it as you walk. So you can see how this would affect a NFL quarterback. Every time Brady plants his foot to throw a pass, he was transferring his weight through that fractured bone, leading to a great deal of pain. So what can your podiatrist do to help Tom Brady and anyone else with a stress fracture? Well it depends on a case-by-case basis, but treatment ranges from offloading the fractured foot to surgery. Tom Brady had a screw put in his bone. This was done because the screw will compress the 2 parts of bone, therefore accelerating the healing process and getting it out of that “chronic” status. These patients could also be put in a cast to help the healing. For concerns about your feet, please come by and see Dr.Grimm and Dr.Pattison of Foot Associates of Central Texas.
Tom Brady suffered a chronic stress fracture of the navicular bone. This is a small bone on the inside of your foot that gets a considerable amount of force put through it. Brady was said to have played through this injury for a major part of the season. Stress fractures are a little different than normal breaks. Stress fractures occur from a long repetitive stress on the bone, possibly caused by muscle pulling on its bony attachments. Normal fractures are usually a specific instance of trauma. The concern with a stress fracture in the navicular bone is that your weight transfers through it as you walk. So you can see how this would affect a NFL quarterback. Every time Brady plants his foot to throw a pass, he was transferring his weight through that fractured bone, leading to a great deal of pain. So what can your podiatrist do to help Tom Brady and anyone else with a stress fracture? Well it depends on a case-by-case basis, but treatment ranges from offloading the fractured foot to surgery. Tom Brady had a screw put in his bone. This was done because the screw will compress the 2 parts of bone, therefore accelerating the healing process and getting it out of that “chronic” status. These patients could also be put in a cast to help the healing. For concerns about your feet, please come by and see Dr.Grimm and Dr.Pattison of Foot Associates of Central Texas.
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