1/19. An unusual case of bilaterally symmetrical neuropathic osteoarthropathy of the midfoot as a result of lyme disease-induced peripheral neuropathy: a case report.The first known report of a patient with lyme disease-induced peripheral neuropathy resulting in bilaterally symmetrical "Charcot" changes of the midfoot is reported. An extensive review of the literature failed to produce any known cases of neuropathic osteoarthropathy that would be linked directly or indirectly with lyme disease-induced peripheral neuropathy. The relationship between lyme disease, the secondary neurologic manifestations caused by the infection, and neuropathic osteoarthropathy are discussed.- - - - - - - - - - ranking = 1keywords = osteoarthropathy (Clic here for more details about this article) |
2/19. Intraosseous epidermoid inclusion cyst in a great toe. A case report and review of the literature.Epidermoid inclusion cysts are benign lesions that occasionally occur in the distal phalanges of the fingers but are less frequently identified and underreported in the toes. We describe a 55-year-old man with a history of work-related trauma followed by painful expansion of his right great toe, resulting in great anxiety. Imaging studies revealed a radiolucent lesion in the distal phalanx of his right hallux. Clinical differential diagnoses included the possibility of an intramedullary inclusion cyst and other various radiolucent lesions. During surgery, a cystic lesion that contained creamy material was discovered. Frozen section diagnosis of the lesion was an intraosseous epidermoid inclusion cyst. The lesion was removed and the patient recovered uneventfully. Although it has been reported that an unduly large number of phalangeal cysts have been treated by amputation, the judicious use of intraoperative frozen sections can prevent this scenario.- - - - - - - - - - ranking = 7.1483712258175E-5keywords = finger (Clic here for more details about this article) |
3/19. Ungual basal cell carcinoma on the fifth toe mimicking chronic dermatitis: case study.BACKGROUND: The finger, toe, and nail unit are rare sites of basal cell carcinoma (BCC). Only a few patients with BCC of the foot have been described in the world literature, and ungual BCC is even less frequent. OBJECTIVE: To discuss through a case report the clinical features and diagnosis of BCC of the foot. methods: We report an unusual case of BCC of the nail unit of the fifth toe of an elderly woman that mimicked chronic dermatitis. CONCLUSION: Our case clearly highlights the need for biopsy and histopathologic examination whenever we see inflammatory lesions with a loss of substance that are refractory to systemic or topical treatments.- - - - - - - - - - ranking = 7.1483712258175E-5keywords = finger (Clic here for more details about this article) |
4/19. [Charcot foot treated by correction and arthrodesis of the hindfoot]THE PROBLEM: First patient: neuropathic osteoarthropathy with severely deformed foot, plantar ulceration and recurrent purulent infections. Second patient: diabetic osteoarthropathy with pathologic fracture. CLINICAL FINDINGS: First patient: 50-year-old man with hereditary sensory and motor neuropathy, plantar ulceration, equinus of the hindfoot, and extensive destruction of all bones of the foot. Recurrent infections necessitated repeated surgical interventions during the last 7 years. At the time of admission purulent infection of the foot. Healing after debridement including a resection of metatarsal bones and part of sequestrated bones of the foot. Patient was left with a severe equinus of the hindfoot. TREATMENT OPTIONS: Orthopedic shoes with or without below-knee orthesis. Lengthening of the achilles tendon and plantar alignment of the calcaneus. arthrodesis of the hindfoot. Below-knee amputation, if necessary as a primary procedure to combat infection. THE SOLUTION: arthrodesis of the hindfoot after realignment; an amputation of the foot was refused. SURGICAL TECHNIQUE: Two-stage procedure: treatment of infection followed by astragalectomy and tibiocalcaneal arthrodesis achieved with cancellous lag screws. Bridging of the area of resection with a segment of the fibula. RESULT: Bony fusion and full load bearing in an orthopedic shoe after 3 months. recurrence of ulcerations after 20 and 27 months due to wear of ill-fitting shoes. The accompanying purulent process forced the authors to resort to a below-knee amputation and fitting of a prosthesis. Second patient: of this patient only radiographs with a retrograde introduced intramedullary nail are shown.- - - - - - - - - - ranking = 0.33333333333333keywords = osteoarthropathy (Clic here for more details about this article) |
5/19. Acquired constriction ring syndrome.Acquired constriction ring syndrome is a clinical condition of infancy characterized by circumferential constriction of a toe or another appendage, such as fingers and genitalia. The foot and ankle specialist should be aware of this condition because vascular obstruction of the affected appendage can rapidly lead to gangrene and autoamputation. Treatment consists of prompt identification and removal of the constricting foreign material. Although this condition is uncommon, it can lead to digital loss. Early treatment yields a good prognosis. A case report is presented of a 9-week-old infant who experienced acquired constriction ring syndrome caused by a strand of hair wrapped around the third and fourth toes that was treated by unwinding the hair under loupe magnification.- - - - - - - - - - ranking = 7.1483712258175E-5keywords = finger (Clic here for more details about this article) |
6/19. The diabetic foot with synovial cyst.Diabetic lower extremity infections, frequently polymicrobial, are at times fascinating though frustrating for the practitioner to treat. The classical triad of neuropathy, infection, and angiopathy is the hallmark of diabetic foot pathology. One of the main forms demonstrating the severe long-term neuropathic disease is called osteoarthropathy or Charcot joint. This is usually relatively painless, always progressive, and frequently destructive. It generally attacks the midtarsal joint and eventually changes the entire architecture of the foot, causing the so-called "rocker bottom" foot type. We present a case of a severely destructive Charcot foot that caused a large synovial cyst because of its vast underlying osseous pathology. The morbidity and mortality of these infections can be minimized by understanding the unique challenges these individuals offer the practitioner.- - - - - - - - - - ranking = 0.16666666666667keywords = osteoarthropathy (Clic here for more details about this article) |
7/19. Osteocutaneous flap from the big toe for repair of osteomyelitis of the second toe.The free vascularized osteocutaneous flap from the big toe has been offered as a solution for the reconstruction of the distal phalanx of the fingers. As another important application of this flap, it is recommended that the flap pedicled with the plantar vessels can easily cover the defect involving the bone of the second toe.- - - - - - - - - - ranking = 7.1483712258175E-5keywords = finger (Clic here for more details about this article) |
8/19. Osteoarthropathy in hereditary sensory radicular neuropathy. A case report.A young man had hereditary sensory radicular neuropathy with relapsing ulcer of the foot and, in addition to previously known clinical features, osteoarthropathy with hallux valgus, metatarsus primus varus, exostosis, and pes planus.- - - - - - - - - - ranking = 0.16666666666667keywords = osteoarthropathy (Clic here for more details about this article) |
9/19. Combined leukocyte and bone imaging used to evaluate diabetic osteoarthropathy and osteomyelitis.Six diabetic patients with roentgenographic finding of osteomyelitis, osteoarthropathy, or both, had combined leukocyte and bone imaging. Bone images demonstrated increased activity in all cases, including three without osteomyelitis. Leukocyte images, however, showed increased activity in only the three cases of osteomyelitis. There was minimal or no activity in the other three cases where osteoarthropathy was ultimately believed to be the basis of the roentgenographic and bone imaging changes.- - - - - - - - - - ranking = 1keywords = osteoarthropathy (Clic here for more details about this article) |
10/19. Persistent skin ulcers, mutilations, and acro-osteolysis in hereditary sensory and autonomic neuropathy with phospholipid excretion. Report of a family.We observed three children in a Turkish family who from early childhood had deformations of the feet and torpid ulcers with subfocal osteomyelitis and osteolysis, which subsequently led to amputations. The fingers showed ainhumlike constriction bands and spontaneous amputations. Neurologic studies revealed an almost complete sensory and autonomic loss affecting all modalities and a marked involvement of motor fibers. The clinical symptoms fulfill many of the hallmarks of hereditary sensory and autonomic neuropathy type II, including autosomal recessive inheritance, onset of symptoms in childhood, and mutilating acropathy. A high urinary excretion of sphingomyelin and lecithin suggests that the pathogenic mechanism may be a disorder of phospholipid metabolism.- - - - - - - - - - ranking = 7.1483712258175E-5keywords = finger (Clic here for more details about this article) |
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