A bunion is seen as an enlargement or “bump” on the inside of the foot near the big toe.
In more severe cases when the big toe joint is unable to move at all, the condition is called hallux rigidus (rigid big toe joint).
A tailor’s bunion (bunionette)is seen as an enlargement or “bump” on the outside of the foot near the little toe.
A callus is an area of thickened skin located on the bottom of the foot, in most cases on the ball of the foot and/or heel.
Hammer Toes occur when the tendons and ligaments around the toes become contracted and the toes take on a “claw-like” appearance.
A soft corn forms between the toes when the bony prominence known to doctors as the “condyle” of a toe rubs against the condyle of the adjacent toe while walking.
The most common cause of thick toenails is a fungus infection similar or identical to the fungus that causes “athlete’s foot.”
An Ingrown Toenail occurs when the side of a toenail begins to cut through the surrounding skin which is referred to by doctors as the ungualabia or “nail lip.”
Morton’s Neuroma occurs when one of the nerves on the bottom of the foot becomes “pinched” between two adjacent metatarsal bones or the base of the bones of two adjacent toes.
EPAT is an acronym for Extracorporeal Pulse Activation Treatment. “Extracorporeal” means “outside the body.”
Heel pain is usually caused by acute or chronic inflammation of the plantar fascia, a ligament-like structure located on the bottom of the foot.
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Podiatry Exam & Consultation
An ulceration is an absence of or defect in the normal lining of the skin layers (epidermis and dermis). In a sense, an ulceration is a hole or cavity in the skin that may be wet or dry and potentially, very resistive to healing. Patients with diabetes, poor circulation and those that are bedridden may have increased tendencies to develop ulcerations. The symptom level, clinical appearance, and response to therapy are largely dependent upon the type and location of the ulceration and the health of patient.
There are many types of ulcers including those caused by loss of sensation of the skin, decreased blood flow, pressure to a specific area of the foot and ulcers due to problems with the valves in the veins.
The diabetic ulceration is caused by an unhealthy condition of the nerves. Because the nerves are debilitated, they do not function properly and result in a loss of sensation. A diabetic patient may step on a needle or other object in the shoe and not even be aware of the problem due to reduced sensation. The skin will eventually break down and result in an ulceration.
Ischemic ulcerations are ulcers that are caused by decreased blood flow and poor blood supply to the feet due to calcified arteries or blockages of the blood vessels. These are the most painful of all the ulcers. Because the skin is not getting the nourishment it needs to survive from the arteries, it begins to die. This often leads to an ulceration.
A pressure ulceration is caused when a portion of the foot is left in contact with an area such as a bed mattress for an excessive period of time. This type of ulceration is commonly seen in patients that are bedridden and unable to move on their own. The pressure to the area cuts off the blood supply, which can cause tissue death leading to an ulceration.
A venous stasis ulceration occurs due to an incompetent or faulty valve between the superficial and deep veins in the legs. This results in fluid being backed up into the superficial veins. Eventually there is too much fluid in the leg. The fluid has nowhere to go and so it begins to weep onto the skin. Eventually an ulceration will occur.
There are many different treatments for ulcers and the type of ulceration involved largely determines the specific method of care. In general, ulcers are treated with debridement (removal) of the surrounding tissue and any nonviable tissue. This will help relieve pressure from the ulcer. Some patients are treated with non-weight bearing of the foot to help decrease pressure on the ulcer. Topical wound gels and creams are also used to keep certain ulcers clean and hydrated. Some gels even help remove dead tissue. The treatment of ischemic ulcerations may require revascularization procedures by a vascular surgeon to increase the blood supply to the feet. Venous stasis ulcers are often treated with compression dressings to help squeeze the fluid out of the legs and back into circulation. These ulcers are also treated with wound gels. Appropriate ulcer therapy can be very effective but often requires time, patience and cooperation on the part of the patient.