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Journal of the American Podiatric Medical Association is published by MDPI from Volume 116 Issue 1 (2026). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with American Podiatric Medical Association.

J. Am. Podiatr. Med. Assoc., Volume 107, Issue 3 (05 2017) – 16 articles , Pages 175-263

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Article
Oldest Mummified Case of Hallux Valgus from Ancient Egypt
by Albert Isidro and Assumpció Malgosa
J. Am. Podiatr. Med. Assoc. 2017, 107(3), 261-263; https://doi.org/10.7547/16-041 - 1 May 2017
Cited by 2 | Viewed by 62
Abstract
Hallux valgus is the most common orthopedic problem of the adult foot. The etiology can be congenital, associated with the occurrence of metatarsus primus varus, or acquired, which is closely related to wearing ill-fitting shoes. Hallux valgus occurs almost exclusively in shod societies [...] Read more.
Hallux valgus is the most common orthopedic problem of the adult foot. The etiology can be congenital, associated with the occurrence of metatarsus primus varus, or acquired, which is closely related to wearing ill-fitting shoes. Hallux valgus occurs almost exclusively in shod societies and, therefore, is a very uncommon finding in archaeological remains. We present a partial first ray of the left foot belonging to a dismembered Egyptian mummy recovered in the necropolis of Sharuna (Middle Egypt) and dated to the end of the Old Kingdom (circa 2100 BC). The mummification process led to a metatarsophalangeal joint in connection by means of soft tissues. The alignment of this joint could be diagnosed as a hallux valgus. Further examination showed a metatarsophalangeal angle of 288. After a comprehensive literature search and noting that all of the previous cases were described by indirect factors, such as mounting the joint in dry bones, we can state with certainty that the piece we present herein is the oldest case of mummified hallux valgus. (J Am Podiatr Med Assoc 107(3): 261-263, 2017) Full article
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Article
Glomus Tumor of the Toe. An Anatomical Variant
by Robert L.B. Sprinkle III, Omar P. Sangueza and Gregory A. Schwartz
J. Am. Podiatr. Med. Assoc. 2017, 107(3), 257-260; https://doi.org/10.7547/15-161 - 1 May 2017
Cited by 13 | Viewed by 61
Abstract
A glomus tumor is an uncommon, predominantly benign, neoplastic lesion that primarily involves a thermoregulatory microvascular apparatus, the glomus body. Although these lesions can occur anywhere in the body, the subungual tissue of the hand represents the most common presentation site. Glomus tumors [...] Read more.
A glomus tumor is an uncommon, predominantly benign, neoplastic lesion that primarily involves a thermoregulatory microvascular apparatus, the glomus body. Although these lesions can occur anywhere in the body, the subungual tissue of the hand represents the most common presentation site. Glomus tumors are not often encountered in the foot. Symptoms traditionally include the classic triad of pain, pressure, and cold sensitivity. This case report describes a variant location for a glomus tumor in the subcuticular tissue adjacent to the medial middle phalanx of the second toe. The nonsubungual location for this presentation should prompt the inclusion of glomus tumor in a digital soft-tissue lesion differential diagnosis. The lesion was excised surgically and was subsequently diagnosed histopathologically as a glomus tumor. (J Am Podiatr Med Assoc 107(3): 257-260, 2017) Full article
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Article
Posttraumatic Retronychia of the Foot with Clinical and Ultrasound Correlation
by Mariana Pizarro, Nicolás Pieressa and Ximena Wortsman
J. Am. Podiatr. Med. Assoc. 2017, 107(3), 253-256; https://doi.org/10.7547/16-076 - 1 May 2017
Cited by 19 | Viewed by 55
Abstract
Retronychia, the posterior embedding of the nail bed into the proximal nail fold, can be a complex clinical dermatologic diagnosis that may mimic other inflammatory ungual diseases or tumors of the nail. It has been related to a history of severe systemic conditions [...] Read more.
Retronychia, the posterior embedding of the nail bed into the proximal nail fold, can be a complex clinical dermatologic diagnosis that may mimic other inflammatory ungual diseases or tumors of the nail. It has been related to a history of severe systemic conditions that secondarily affect the nail matrix and is commonly associated with onychomadesis. We present a case of retronychia of the foot with a purely traumatic origin, nonconcomitant with onychomadesis, that was diagnosed by color Doppler ultrasound in a long-time practitioner of martial arts who was otherwise healthy. Color Doppler ultrasound is an excellent imaging technique for supporting the diagnosis of retronychia. It provides information on the exact location and morphology of the nail plate as well as the presence of inflammatory signs in the ungual and proximal periungual regions. Additionally, this imaging technique can support the differential diagnosis with other nail conditions. Since there are many sports or activities that can potentially injure the toenails, retronychia may be an underestimated entity and the present case can raise the awareness of this condition and show the usefulness of color Doppler ultrasound. (J Am Podiatr Med Assoc 107(3): 253-256, 2017) Full article
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Article
Cryptococcal Osteomyelitis of the First Metatarsal Head in an Immunocompetent Patient. A Case Report
by Jae Hoon Ahn, ChanJoo Park, Choong Woo Lee and Yoon-Chung Kim
J. Am. Podiatr. Med. Assoc. 2017, 107(3), 248-252; https://doi.org/10.7547/16-067 - 1 May 2017
Cited by 8 | Viewed by 58
Abstract
Most fungal infections primarily occur in immunocompromised patients. We describe a case of osteomyelitis involving the first metatarsal head due to Cryptococcus neoformans in a previously healthy immunocompetent patient. She was treated with surgical debridement combined with antifungal drug therapy for 6 months. [...] Read more.
Most fungal infections primarily occur in immunocompromised patients. We describe a case of osteomyelitis involving the first metatarsal head due to Cryptococcus neoformans in a previously healthy immunocompetent patient. She was treated with surgical debridement combined with antifungal drug therapy for 6 months. At 5-year follow-up, she remained symptom free with full range of motion of the first metatarsophalangeal joint. Fungal osteomyelitis should be considered as a possible cause in osteolytic lesions in the metatarsal bone. (J Am Podiatr Med Assoc 107(3): 248-252, 2017) Full article
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Article
Angioleiomyoma of the Lower Leg
by Robert L.B. Sprinkle III, Omar P. Sangueza and Ashleigh E. Wells
J. Am. Podiatr. Med. Assoc. 2017, 107(3), 244-247; https://doi.org/10.7547/16-044 - 1 May 2017
Cited by 8 | Viewed by 58
Abstract
Angioleiomyomas are benign tumefactions that originate from smooth muscle in vascular structures and are difficult to definitively diagnose preoperatively. Although these lesions are rarely encountered in the foot, the lower extremity is the most common site of occurrence. An angioleiomyoma typically manifests as [...] Read more.
Angioleiomyomas are benign tumefactions that originate from smooth muscle in vascular structures and are difficult to definitively diagnose preoperatively. Although these lesions are rarely encountered in the foot, the lower extremity is the most common site of occurrence. An angioleiomyoma typically manifests as a small, painful, solitary, mobile lesion. This case report describes a lateral retromalleolar para–Achilles tendon insertional location for a moderately sized immobile solid tumefaction in the subcutaneous tissues. The lesion was nonpainful and progressively enlarged over 5 years. An excisional biopsy was performed, and the nodular lesion was subsequently diagnosed histopathologically as an angioleiomyoma. Owing to the ambiguous nature of the clinical findings, angioleiomyoma should be included in the differential diagnosis of lower-extremity soft-tissue manifestations. (J Am Podiatr Med Assoc 107(3): 244-247, 2017) Full article
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Article
Management Considerations for a Retained Plantar Knife Injury
by Devon Rayasa, Garrett Sessions and Maciej Witkos
J. Am. Podiatr. Med. Assoc. 2017, 107(3), 240-243; https://doi.org/10.7547/15-197 - 1 May 2017
Viewed by 57
Abstract
A 13-year-old girl presented to the emergency department in stable condition with a retained penetrating knife wound injury in her right foot. Routine radiographs taken of the foot revealed deep tissue penetration by the knife without frank bony involvement. It was decided to [...] Read more.
A 13-year-old girl presented to the emergency department in stable condition with a retained penetrating knife wound injury in her right foot. Routine radiographs taken of the foot revealed deep tissue penetration by the knife without frank bony involvement. It was decided to remove the object in the operating room. Simple removal was performed, followed by wound exploration. The patient was admitted to the hospital for one night of observation and then was discharged without further complications. (J Am Podiatr Med Assoc 107(3): 240-243, 2017) Full article
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Article
Lower-Extremity Infections Caused by Serratia marcescens. A Report of Three Cases and a Literature Review
by Luis Marin, Raymond Rowan, Ana Mantilla, Bamidele Olupona and Ann MacIntyre
J. Am. Podiatr. Med. Assoc. 2017, 107(3), 231-239; https://doi.org/10.7547/15-180 - 1 May 2017
Cited by 11 | Viewed by 69
Abstract
Serratia marcescens is a ubiquitous, facultatively anaerobic, gram-negative bacillus that has been cited to cause infection in immunocompromised populations. In the literature, S marcescens infections of the lower extremity have presented as granulomatous ulceration, abscess, bullous cellulitis, and necrotizing fasciitis. Herein we present [...] Read more.
Serratia marcescens is a ubiquitous, facultatively anaerobic, gram-negative bacillus that has been cited to cause infection in immunocompromised populations. In the literature, S marcescens infections of the lower extremity have presented as granulomatous ulceration, abscess, bullous cellulitis, and necrotizing fasciitis. Herein we present a series of three cases of lower-extremity infections in which S marcescens was the sole or a contributing pathogen. We discuss the commonalities of these three cases as well as with those previously cited. All three patients presented with some combination of a similar set of clinical characteristics, including bullae formation, liquefactive necrosis, and black necrotic eschar. All three patients were diabetic and had peripheral vascular disease. Full article
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Article
Dorsal Fracture-Dislocation of the Tarsal Navicular. Case Report and Review of a Rare Injury
by Isidro Jimenez, Juan Pedro Rodriguez-Alvarez and Ricardo Navarro-Navarro
J. Am. Podiatr. Med. Assoc. 2017, 107(3), 226-230; https://doi.org/10.7547/15-103 - 1 May 2017
Cited by 4 | Viewed by 66
Abstract
Fracture-dislocations of the tarsal navicular are rare and highly complex injuries to the midfoot. The only published data on this type of fracture are clinical case reports. These injuries are normally caused by high-energy trauma, and their pathophysiology and most appropriate treatment remain [...] Read more.
Fracture-dislocations of the tarsal navicular are rare and highly complex injuries to the midfoot. The only published data on this type of fracture are clinical case reports. These injuries are normally caused by high-energy trauma, and their pathophysiology and most appropriate treatment remain unclear. We report a clinical case of a dorsal fracturedislocation of the tarsal navicular bone associated with a medial swivel dislocation of the Chopart joint caused by a bicycle fall in a 20-year-old healthy man. Open reduction and percutaneous pinning in a novel arrangement was performed, with an excellent outcome 18 months after the injury. (J Am Podiatr Med Assoc 107(3): 226-230, 2017) Full article
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Article
Accessory Lesser Metatarsal Sesamoids in All of the Metatarsophalangeal Joints. A Case Report
by Selim Ergun, Baransel Saygı, İlyas Arslan and Yakup Yıldırım
J. Am. Podiatr. Med. Assoc. 2017, 107(3), 223-225; https://doi.org/10.7547/15-195 - 1 May 2017
Cited by 1 | Viewed by 54
Abstract
Lesser metatarsal sesamoids are one of the most common accessory bones of the foot and are most commonly seen at the fifth metatarsophalangeal joint. They are rarely seen in other metatarsophalangeal joints. In the literature, there are reports of solitary accessory sesamoid bones [...] Read more.
Lesser metatarsal sesamoids are one of the most common accessory bones of the foot and are most commonly seen at the fifth metatarsophalangeal joint. They are rarely seen in other metatarsophalangeal joints. In the literature, there are reports of solitary accessory sesamoid bones seen at lesser metatarsophalangeal joints. We report the case of a 68-year-old woman with lesser metatarsal sesamoids accompanying all of the metatarsophalangeal joints. Full article
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Article
Structural Changes in the Lower Extremities in Boys Aged 7 to 12 Years Who Engage in Moderate Physical Activity. An Observational Longitudinal Study
by Gabriel Gijon-Nogueron, Salvador Diaz-Miguel, Eva Lopezosa-Reca and Jose Antonio Cervera-Marin
J. Am. Podiatr. Med. Assoc. 2017, 107(3), 215-222; https://doi.org/10.7547/15-193 - 1 May 2017
Cited by 1 | Viewed by 57
Abstract
Background: Physical activity in children may provide health benefits. We sought to consider the practice of soccer as a possible major factor in the development of the lower limb. The study is based on 3-year data for a group of children who practice [...] Read more.
Background: Physical activity in children may provide health benefits. We sought to consider the practice of soccer as a possible major factor in the development of the lower limb. The study is based on 3-year data for a group of children who practice this sport. Methods: For 3 years we monitored 53 children who practiced soccer 3 times a week and had engaged in 2 years of continuous sports activity. Their mean ± SD age was 8.49 ± 2.01 years in the first year. Each year, Foot Posture Index, valgus index, subtalar joint axis, and Q angle for the knee were analyzed. Results: The mean ± SD Foot Posture Index scores ranged from 5.38 ± 1.79 in the right foot and 4.49 ± 1.67 in the left foot in the first year to 4.64 ± 2.51 and 4.34 ± 2.26, respectively, in the third year. The valgus index for the same period ranged from 14.058 ± 1.518 (right) and 13.888 ± 1.468 (left) to 13.098 ± 1.288 and 13.078 ± 1.078, respectively. In the knee, the Q angle ranged from 12.838 ± 1.988 (right) and 12.748 ± 1.688 (left) to 13.178 ± 1.458 and 13.268 ± 1.468, respectively. In the subtalar joint, the changes were 37.73% right and 30.19% left between the first and third years toward a neutral subtalar joint axis. Conclusions: These results show that although playing soccer might cause structural changes in the lower limb, these alterations should not be considered harmful because they may be influenced by age as well. (J Am Podiatr Med Assoc 107(3): 215-222, 2017) Full article
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Article
Evaluation of Plantar Pressure Distribution in Relationship to Body Mass Index in Czech Women During Walking
by Kristína Tománková, Miroslava PřIdalová, Zdenek Svoboda and Roman Cuberek
J. Am. Podiatr. Med. Assoc. 2017, 107(3), 208-214; https://doi.org/10.7547/15-143 - 1 May 2017
Cited by 17 | Viewed by 75
Abstract
Background: Excessive body weight seems to be a risk factor for foot loading. We sought to investigate the effect of different body mass index (BMI) levels on plantar pressure distribution during walking. Methods: In total, 163 women aged 45 to 65 years (mean [...] Read more.
Background: Excessive body weight seems to be a risk factor for foot loading. We sought to investigate the effect of different body mass index (BMI) levels on plantar pressure distribution during walking. Methods: In total, 163 women aged 45 to 65 years (mean ± SD: age, 57.4 ± 5.3 years; BMI, 27.0 ± 5.3) participated in the study. The women were divided, on the basis of BMI, into a normal-weight, overweight, or obese group. The study used the four following plantar pressure parameters (PPPs): contact percentage, absolute pressure impulse, relative pressure impulse, and absolute peak pressure, which were recorded in ten foot regions using a pressure measurement system. Results: The normal-weight group, compared with the overweight and obese groups, had significantly lower absolute PPP values. In the hallux, second through fifth metatarsals, midfoot, and heel regions, we observed significant between-group differences in the two absolute PPPs (peak pressure and pressure impulse) (P < .001). Between-group differences in the relative PPPs were found in the fourth metatarsal, midfoot, and medial heel (relative impulse) and in the second metatarsal (contact percentage) (P < .001). Conclusions: Higher BMI values correspond to a higher load on the foot during walking in women. The relative foot load in obese women is characterized by a pressure increase in the lateral forefoot and midfoot and by a pressure decrease in the medial heel. (J Am Podiatr Med Assoc 107(3): 208-214, 2017) Full article
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Article
A Novel Thermochromic Liquid Crystal Fabric Design for the Early Detection of High-Risk Foot Complications. A Proof-of-Concept Study
by Jonathan D. LeSar, Nilin M. Rao, Nicholas M. Williams, Jeffrey P. Pantano, Melissa L. Ricci, Lawrence S. Osher, Vincent J. Hetherington and Jill S. Kawalec
J. Am. Podiatr. Med. Assoc. 2017, 107(3), 200-207; https://doi.org/10.7547/15-151 - 1 May 2017
Cited by 8 | Viewed by 58
Abstract
Background: We developed a prototype of a novel thermochromic liquid crystal (TLC)– coated fabric with an extended temperature range and enhanced sensitivity. By incorporating color and pattern recognition into the fabric, rapid determination of the underlying pedal temperature is facilitated. The purpose of [...] Read more.
Background: We developed a prototype of a novel thermochromic liquid crystal (TLC)– coated fabric with an extended temperature range and enhanced sensitivity. By incorporating color and pattern recognition into the fabric, rapid determination of the underlying pedal temperature is facilitated. The purpose of this study was to evaluate the accuracy of the TLC fabric as a potential diagnostic aid for identifying complications in the high-risk foot. Methods: The hands of 100 individuals were used to compare the mean maximum temperatures indicated by the fabric versus standard thermal camera images. Findings were statistically analyzed using a paired t test, with significance defined as P < .05. Results: Except for the tip of the thumb and regions in the palm, there were no statistically significant differences between mean maximum temperatures measured with the thermal camera and those detected with the TLC fabric. Minor differences were relatively consistent in all nine regions of the hand and were not considered to be clinically significant. Conclusions: Using direct visual analysis, we demonstrated that a novel TLC fabric could accurately map temperatures in the palmar surface of the hand. The findings support the continued development of a temperature-sensitive sock that can be used in the home to monitor for temperature changes that may indicate the onset of complications in the high-risk foot. (J Am Podiatr Med Assoc 107(3): 200-207, 2017) Full article
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Article
Comparative Effectiveness of Radial Extracorporeal Shockwave Therapy and Ultrasound-Guided Local Corticosteroid Injection Treatment for Plantar Fasciitis
by Sehriban Hocaoglu, Umit Erkan Vurdem, Mehtap Aykac Cebicci, Serap Tomruk Sutbeyaz, Zuhal Guldeste and Serap Gurek Yunsuroglu
J. Am. Podiatr. Med. Assoc. 2017, 107(3), 192-199; https://doi.org/10.7547/14-114 - 1 May 2017
Cited by 25 | Viewed by 66
Abstract
Background: We compared the long-term clinical and ultrasonographic effects of radial extracorporeal shockwave therapy (rESWT) versus ultrasound-guided corticosteroid injection treatment in patients with plantar fasciitis unresponsive to conservative therapy. Methods: Seventy-two patients with unilateral plantar fasciitis were randomized to receive either rESWT (three [...] Read more.
Background: We compared the long-term clinical and ultrasonographic effects of radial extracorporeal shockwave therapy (rESWT) versus ultrasound-guided corticosteroid injection treatment in patients with plantar fasciitis unresponsive to conservative therapy. Methods: Seventy-two patients with unilateral plantar fasciitis were randomized to receive either rESWT (three times once per week) (n = 36) or corticosteroid treatment (a single 1-mL dose of betamethasone sodium plus 0.5 mL of prilocaine under ultrasound guidance by injection into the plantar fascia) (n = 36). The primary outcome measures were visual analog scale (VAS) and Foot Function Index (FFI) scores. Secondary outcome measures included the heel tenderness index (HTI) score and plantar fascia thickness (PFT) as obtained by ultrasound examination. All of the assessments were performed at baseline and 1, 3, and 6 months after treatment. Results: Significant improvements were observed in the rESWT group in VAS, HTI, and FFI scores and PFT at the end of treatment and were maintained during follow-up. Posttreatment improvements in VAS, HTI, and FFI scores and PFT were also seen in the corticosteroid group but were not maintained for VAS and FFI scores after the completion of therapy and were lost at 1 and 6 months, respectively. No serious treatment-related complications occurred. Conclusions: Both rESWT and corticosteroid injection therapy are effective modalities for treatment of chronic plantar fasciitis. However, rESWT seems to be superior to corticosteroid injection therapy due to its longer duration of action. (J Am Podiatr Med Assoc 107(3): 192-199, 2017) Full article
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Article
Characteristics Predicting the Outcome in Individuals with Diabetic Foot Ulcerations
by Lourdes Vella and Cynthia Formosa
J. Am. Podiatr. Med. Assoc. 2017, 107(3), 180-191; https://doi.org/10.7547/15-070 - 1 May 2017
Cited by 9 | Viewed by 50
Abstract
Background: We sought to determine patient and ulcer characteristics that predict wound healing in patients living with diabetes. Methods: A prospective observational study was conducted on 99 patients presenting with diabetic foot ulceration. Patient and ulcer characteristics were recorded. Patients were followed up [...] Read more.
Background: We sought to determine patient and ulcer characteristics that predict wound healing in patients living with diabetes. Methods: A prospective observational study was conducted on 99 patients presenting with diabetic foot ulceration. Patient and ulcer characteristics were recorded. Patients were followed up for a maximum of 1 year. Results: After 1 year of follow-up, ulcer characteristics were more predictive of ulcer healing than were patient characteristics. Seventy-seven percent of ulcers had healed and 23% had not healed. Independent predictors of nonhealing were ulcer stage (P = .003), presence of biofilm (P = .020), and ulcer depth (P = .028). Although this study demonstrated that the baseline hemoglobin A1c reading at the start of the study was not a significant predictor of foot ulcer outcome (P = .603, resolved versus amputated), on further statistical analyses, when hemoglobin A1c was compared with the time taken for complete ulcer healing (n = 77), it proved to be significant (P = .009). Conclusions: The factors influencing healing are ulcer stage, presence of biofilm, and ulcer depth. These findings have important implications for clinical practice, especially in an outpatient setting. Prediction of outcome may be helpful for health-care professionals in individualizing and optimizing clinical assessment and management of patients. Identification of determinants of outcome could result in improved health outcomes, improved quality of life, and fewer diabetes-related foot complications.
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Article
A 5-Year Review of Clinical Outcome Measures Published in the Journal of the American Podiatric Medical Association and the Journal of Foot and Ankle Surgery
by Todd Hasenstein, Timothy Greene and Andrew J. Meyr
J. Am. Podiatr. Med. Assoc. 2017, 107(3), 176-179; https://doi.org/10.7547/16-157 - 1 May 2017
Cited by 3 | Viewed by 49
Abstract
This investigation presents a review of all of the clinical outcome measures used by authors and published in the Journal of the American Podiatric Medical Association and the Journal of Foot and Ankle Surgery from January 1, 2011, to December 31, 2015. Of [...] Read more.
This investigation presents a review of all of the clinical outcome measures used by authors and published in the Journal of the American Podiatric Medical Association and the Journal of Foot and Ankle Surgery from January 1, 2011, to December 31, 2015. Of 1,336 articles published during this time frame, 655 (49.0%) were classified as original research and included in this analysis. Of these 655 articles, 151 (23.1%) included at least one clinical outcome measure. Thirty-seven unique clinical outcome scales were used by authors and published during this period. The most frequently reported scales in the 151 included articles were the American Orthopaedic Foot and Ankle Society scales (54.3%; n = 82), visual analog scale (35.8%; n = 54), Medical Outcomes Study Short Form Health Survey (any version) (10.6%; n = 16), Foot Function Index (5.3%; n = 8), Maryland Foot Score (4.0%; n =6), and Olerud and Molander scoring system (4.0%; n = 6). Twenty-four articles (15.9%) used some form of original/subjective measure of patient satisfaction/expectation. The results of this investigation detail the considerable variety of clinical outcome measurement tools used by authors in the Journal of the American Podiatric Medical Association and the Journal of Foot and Ankle Surgery and might support the need for a shift toward the consistent use of a smaller number of valid, reliable, and clinically useful scales in the podiatric medical literature. Full article
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Article
Examining Clinical Outcome Measures
by Warren S. Joseph
J. Am. Podiatr. Med. Assoc. 2017, 107(3), 175; https://doi.org/10.7547/8750-7315-107.3.175 - 1 May 2017
Cited by 1 | Viewed by 52
Abstract
In this age of evidencebased medicine, the purpose of original research is to, through rigorous scientific protocols, allow us to make the decision on the best practices we can employ for our patients [...] Full article
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