Journal of the American Podiatric Medical Association

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Open AccessArticle

Acceptance Address APMA House of Delegates Washington, DC. Prospering with a New Spirit of Cooperation April 17, 2005

by Harold B. Glickman

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 331-334; https://doi.org/10.7547/0950331 - 1 May 2005

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Mr. Speaker, members of the House of Delegates, members of the Board of Trustees, past presidents, staff, and honored guests, it is truly an honor for me to stand before you as president of the American Podiatric Medical Association. Full article

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Open AccessArticle

Address to APMA’s House of Delegates

by Lloyd S. Smith

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 328-330; https://doi.org/10.7547/0950328 - 1 May 2005

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Abstract

I have now spent more than 10 years on the APMA Board of Trustees, and my year as APMA president—the leader of our profession—is about to end. Full article

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Open AccessDiscussion

Reliability and Validity of Clinically Assessing First-Ray Mobility of the Foot

by Mary K. Allen

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 322; https://doi.org/10.7547/0950322 - 1 May 2005

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Abstract

To the Editor: I am writing in response to the article published in the September/October 2004 issue of the Journal titled “Reliability and Validity of Clinically Assessing First-Ray Mobility of the Foot” by Mark W [...] Full article

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Open AccessLetter

An Analysis of Articles Published in JAPMA in 2004

by Barbara S. Schlefman

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 320-322; https://doi.org/10.7547/0950320 - 1 May 2005

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Abstract

To the Editor: I have reviewed the articles published in the Journal of the American Podiatric Medical Association (JAPMA) in the six issues of the 2004 calendar year [...] Full article

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Open AccessArticle

Introduction

by Lee J. Sanders

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 309-319; https://doi.org/10.7547/0950309 - 1 May 2005

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Abstract

The article that follows, “Peripheral Arterial Disease in People with Diabetes,” represents the American Diabetes Association’s (ADA’s) Consensus Statement on a common yet frequently underrecognized and undertreated condition. Full article

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Open AccessArticle

Introduction

by Lee J. Sanders

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 307-308; https://doi.org/10.7547/0950307 - 1 May 2005

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Abstract

The article that follows, “Peripheral Arterial Disease in People with Diabetes,” represents the American Diabetes Association’s (ADA’s) Consensus Statement on a common yet frequently underrecognized and undertreated condition. Full article

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Open AccessCommunication

Accurate Nomenclature for Forefoot Nerve Entrapment. A Historical Perspective

by Ethan E. Larson, Stephen L. Barrett, Bruno Battiston, Christopher T. Maloney and A. Lee Dellon

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 298-306; https://doi.org/10.7547/0950298 - 1 May 2005

Cited by 37 | Viewed by 53

Abstract

Current medical nomenclature is often based on the early history of the condition, when the true etiology of the disease or condition was not known. Sadly, this incorrect terminology can become inextricably woven into the lexicon of mainstream medicine. More important, when this [...] Read more.

Current medical nomenclature is often based on the early history of the condition, when the true etiology of the disease or condition was not known. Sadly, this incorrect terminology can become inextricably woven into the lexicon of mainstream medicine. More important, when this is the case, the terminology itself can become integrated into current clinical decision making and ultimately into surgical intervention for the condition. “Morton’s neuroma” is perhaps the most striking example of this nomenclature problem in foot and ankle surgery. We aimed to delineate the historical impetus for the terminology still being used today for this condition and to suggest appropriate terminology based on our current understanding of its pathogenesis. We concluded that this symptom complex should be given the diagnosis of nerve compression and be further distinguished by naming the involved nerve, such as compression of the interdigital nerve to the third web space or compression of the third common plantar digital nerve. Although the nomenclature becomes longer, the pathogenesis is correct, and treatment decisions can be made accordingly. (J Am Podiatr Med Assoc 95(3): 298–306, 2005) Full article

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Open AccessReview

Osteochondroma of the Talar Neck. A Rare Cause of Callosity of the Foot Dorsum

by Selçuk Keser and Ahmet Bayar

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 295-297; https://doi.org/10.7547/0950295 - 1 May 2005

Cited by 14 | Viewed by 47

Abstract

Osteochondroma is the most common benign bone tumor. It rarely affects rearfoot bones, and only a few cases of talar osteochondroma have been reported. We report a case of a solitary osteochondroma of the talus that presented as a painful callus on the [...] Read more.

Osteochondroma is the most common benign bone tumor. It rarely affects rearfoot bones, and only a few cases of talar osteochondroma have been reported. We report a case of a solitary osteochondroma of the talus that presented as a painful callus on the anterior portion of the ankle that was refractory to dermatologic treatment. (J Am Podiatr Med Assoc 95(3): 295–297, 2005) Full article

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Open AccessReview

Cutaneous Larva Migrans. Case Report with Current Recommendations for Treatment

by Jonathan C. O’Quinn and Robert Dushin

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 291-294; https://doi.org/10.7547/0950291 - 1 May 2005

Cited by 9 | Viewed by 52

Abstract

Cutaneous larva migrans is a common skin pathology that occurs in people who have recently visited tropical or subtropical climates. Given the ubiquity of this condition, the podiatric physician may encounter cutaneous larva migrans during clinical practice and should be cognizant of the [...] Read more.

Cutaneous larva migrans is a common skin pathology that occurs in people who have recently visited tropical or subtropical climates. Given the ubiquity of this condition, the podiatric physician may encounter cutaneous larva migrans during clinical practice and should be cognizant of the presenting signs and typical patient history given in these cases. We describe the case of a 62-year-old man who presented with a pruritic, erythematous, serpiginous lesion on the dorsum of his left foot after having vacationed in Florida for several weeks. The patient was treated successfully with oral thiabendazole, 500 mg after meals 4 times daily for 5 days. (J Am Podiatr Med Assoc 95(3): 291–294, 2005) Full article

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Open AccessReview

Focal Tuberculous Osteomyelitis of the Calcaneus Secondary to Direct Extension from an Infected Retrocalcaneal Bursa

by Ibrahim Fikry Abdelwahab, Michael J. Klein, George Hermann and Mohammed Abdul-Quader

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 285-290; https://doi.org/10.7547/0950285 - 1 May 2005

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Abstract

We report a case of focal tuberculous involvement of the posterior margin of the calcaneus with preservation of the articular margin. The route of infection was direct extension through tuberculous retrocalcaneal bursitis, a rare and atypical pathogenesis. Magnetic resonance imaging was helpful in [...] Read more.

We report a case of focal tuberculous involvement of the posterior margin of the calcaneus with preservation of the articular margin. The route of infection was direct extension through tuberculous retrocalcaneal bursitis, a rare and atypical pathogenesis. Magnetic resonance imaging was helpful in ruling out neoplasm and in limiting the diagnosis to an inflammatory infectious process. (J Am Podiatr Med Assoc 95(3): 285–290, 2005) Full article

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Open AccessReview

Percutaneous Tendo Achillis Lengthening to Promote Healing of Diabetic Plantar Foot Ulceration

by Amanda Willrich, Arush K. Angirasa and Ronald A. Sage

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 281-284; https://doi.org/10.7547/0950281 - 1 May 2005

Cited by 19 | Viewed by 47

Abstract

The etiology of ulcerations related to increased plantar pressure in patients with diabetes mellitus is complex but frequently includes a component of gastrocnemius soleus equinus. One viable treatment option is percutaneous tendo Achillis lengthening as a means of increasing dorsiflexory range of motion [...] Read more.

The etiology of ulcerations related to increased plantar pressure in patients with diabetes mellitus is complex but frequently includes a component of gastrocnemius soleus equinus. One viable treatment option is percutaneous tendo Achillis lengthening as a means of increasing dorsiflexory range of motion and decreasing forefoot shear forces. This article presents three case reports illustrating the importance of reducing plantar pressure as a crucial component of treatment of diabetic forefoot ulcerations. (J Am Podiatr Med Assoc 95(3): 281–284, 2005) Full article

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Open AccessArticle

Hallucal Sesamoid Osteonecrosis. An Overlooked Cause of Forefoot Pain

by Gürkan Özkoç, Sercan Akpinar, Metin Özalay, Murat Ali Hersekli, Ayşin Pourbagher, Fazilet Kayaselçuk and Reha N. Tandogan

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 277-280; https://doi.org/10.7547/0950277 - 1 May 2005

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Abstract

Four cases of osteonecrosis of hallucal sesamoids are reported here. Surgical excision of necrotic sesamoid tissue yielded satisfactory results, with the patients reporting no residual pain. Although it has not been frequently addressed in the literature, avascular necrosis of the sesamoid bones should [...] Read more.

Four cases of osteonecrosis of hallucal sesamoids are reported here. Surgical excision of necrotic sesamoid tissue yielded satisfactory results, with the patients reporting no residual pain. Although it has not been frequently addressed in the literature, avascular necrosis of the sesamoid bones should be considered in the differential diagnosis of persistent forefoot pain. Full article

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Open AccessArticle

Arch Index as a Predictor of Pes Planus. A Comparative Study of Indigenous Kenyans and Tanzanians

by Patrick S. Igbigbi, Boniface C. Msamati and Macfenton B. Shariff

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 273-276; https://doi.org/10.7547/0950273 - 1 May 2005

Cited by 26 | Viewed by 84

Abstract

We determined the arch index of able-bodied indigenous Kenyan and Tanzanian individuals free of foot pain by using their dynamic footprints to classify the foot arch type and determine the prevalence of pes planus according to a previously described method. Males had a [...] Read more.

We determined the arch index of able-bodied indigenous Kenyan and Tanzanian individuals free of foot pain by using their dynamic footprints to classify the foot arch type and determine the prevalence of pes planus according to a previously described method. Males had a significantly higher arch index than females in both groups, and the prevalence of pes planus in Kenyans was 432 per 1,000 population, the highest ever documented and twice as high as that in Tanzanians (203 per 1,000 population). The arch index is useful in determining the prevalence of pes planus and possibly predicting pathologic foot conditions, and it may serve as an early warning sign of structural and functional defects of the foot in a given population. Full article

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Open AccessArticle

The Bristol Foot Score. Developing a Patient-Based Foot-Health Measure

by Sue Barnett, Rona Campbell and Ian Harvey

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 264-272; https://doi.org/10.7547/0950264 - 1 May 2005

Cited by 32 | Viewed by 51

Abstract

We sought to develop a patient-centered foot-health assessment tool by conducting in-depth interviews, focus groups, and surveys of relevant patient groups. A total of 400 hospital- and community-based podiatric patients took part in the development of the Bristol Foot Score, which was refined [...] Read more.

We sought to develop a patient-centered foot-health assessment tool by conducting in-depth interviews, focus groups, and surveys of relevant patient groups. A total of 400 hospital- and community-based podiatric patients took part in the development of the Bristol Foot Score, which was refined from a 41-item self-administered questionnaire to one containing 15 items. Podiatric patients easily understood the final questionnaire, and rates of completion were excellent. Overall reliability was high (Cronbach α = .9036), and application of the Bland and Altman technique suggested that the foot score produced stable measurements over time. Statistically significant differences were detected in scores before and after toenail surgery, indicating that the Bristol Foot Score is sensitive to change. A poor level of concordance was found between the Bristol Foot Score and a Chiropody Assessment Criteria Score routinely used by podiatrists to assess the need for podiatric care. The Bristol Foot Score reflects patients’ perceptions of their own foot health, providing a useful additional tool for evaluating the efficacy of interventions and describing foot health within populations. Full article

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Open AccessArticle

Utility of Histopathologic Analysis in the Evaluation of Onychomycosis

by Jeffrey M. Weinberg, Evelyn K. Koestenblatt and Maureen B. Jennings

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 258-263; https://doi.org/10.7547/0950258 - 1 May 2005

Cited by 22 | Viewed by 48

Abstract

Onychomycosis is a common problem seen in clinical practice. Given the differential diagnosis of dystrophic nails, it is helpful to obtain a definitive diagnosis of dermatophyte infection before initiation of antifungal therapy. Potassium hydroxide preparation and fungal culture, which are typically used in [...] Read more.

Onychomycosis is a common problem seen in clinical practice. Given the differential diagnosis of dystrophic nails, it is helpful to obtain a definitive diagnosis of dermatophyte infection before initiation of antifungal therapy. Potassium hydroxide preparation and fungal culture, which are typically used in the diagnosis of these infections, often yield false-negative results. Recent studies have suggested that nail plate biopsy with periodic acid–Schiff stain may be a very sensitive technique for the diagnosis of onychomycosis. In this article, we review the literature on the utility of histopathologic analysis in the evaluation of onychomycosis. Many of these studies indicate that biopsy with periodic acid–Schiff is the most sensitive method for diagnosing onychomycosis. We propose that histopathologic examination is indicated if the results of other methods are negative and clinical suspicion is high; therefore, it is a useful complementary technique in the diagnosis of onychomycosis. Full article

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Open AccessArticle

Maggot Therapy in “Lower-Extremity Hospice” Wound Care. Fewer Amputations and More Antibiotic-Free Days

by David G. Armstrong, Precious Salas, Brian Short, Billy R. Martin, Heather R. Kimbriel, Brent P. Nixon and Andrew J. M. Boulton

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 254-257; https://doi.org/10.7547/0950254 - 1 May 2005

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Abstract

We sought to assess, in a case-control model, the potential efficacy of maggot debridement therapy in 60 nonambulatory patients (mean ± SD age, 72.2 ± 6.8 years) with neuroischemic diabetic foot wounds (University of Texas grade C or D wounds below the malleoli) [...] Read more.

We sought to assess, in a case-control model, the potential efficacy of maggot debridement therapy in 60 nonambulatory patients (mean ± SD age, 72.2 ± 6.8 years) with neuroischemic diabetic foot wounds (University of Texas grade C or D wounds below the malleoli) and peripheral vascular disease. Twenty-seven of these patients (45%) healed during 6 months of review. There was no significant difference in the proportion of patients healing in the maggot debridement therapy versus control group (57% versus 33%). Of patients who healed, time to healing was significantly shorter in the maggot therapy than in the control group (18.5 ± 4.8 versus 22.4 ± 4.4 weeks). Approximately one in five patients (22%) underwent a high-level (above-the-foot) amputation. Patients in the control group were three times as likely to undergo amputation (33% versus 10%). Although there was no significant difference in infection prevalence in patients undergoing maggot therapy versus controls (80% versus 60%), there were significantly more antibiotic-free days during follow-up in patients who received maggot therapy (126.8 ± 30.3 versus 81.9 ± 42.1 days). Maggot debridement therapy reduces short-term morbidity in nonambulatory patients with diabetic foot wounds. Full article

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Open AccessArticle

The Stance Phase of Walking During Late Pregnancy. Temporospatial and Ground Reaction Force Variables

by Janelle K. Lymbery and Wendy Gilleard

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 247-253; https://doi.org/10.7547/0950247 - 1 May 2005

Cited by 76 | Viewed by 55

Abstract

The purpose of this study was to investigate temporospatial and ground reaction force variables in the stance phase of walking during late pregnancy. An eight-camera motion-analysis system was used to record 13 pregnant women at 38 weeks’ gestation and again 8 weeks after [...] Read more.

The purpose of this study was to investigate temporospatial and ground reaction force variables in the stance phase of walking during late pregnancy. An eight-camera motion-analysis system was used to record 13 pregnant women at 38 weeks’ gestation and again 8 weeks after birth. In late pregnancy, there was a wider step width, and mediolateral ground reaction force tended to be increased in a medial direction. The center of pressure moved more medially initially and less anteriorly at 100% of stance in late pregnancy. The differences suggest that women may adapt their gait to maximize stability in the stance phase of walking and to control mediolateral motion. Full article

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Open AccessArticle

Evaluation of Young’s Modulus in Achilles Tendons with Diabetic Neuroarthropathy

by William P. Grant, Eric J. Foreman, Anne S. Wilson, Dwayne A. Jacobus and Renee M. Kukla

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 242-246; https://doi.org/10.7547/0950242 - 1 May 2005

Cited by 30 | Viewed by 58

Abstract

The Achilles tendon of the patient with Charcot’s foot neuroarthropathy has significantly altered physical properties compared with a normal tendon. Twenty-nine Achilles tendons from patients with Charcot’s foot (n = 20) and non-Charcot’s foot controls (n = 9) were loaded onto a biomechanical [...] Read more.

The Achilles tendon of the patient with Charcot’s foot neuroarthropathy has significantly altered physical properties compared with a normal tendon. Twenty-nine Achilles tendons from patients with Charcot’s foot (n = 20) and non-Charcot’s foot controls (n = 9) were loaded onto a biomechanical testing instrument. The biomechanical properties of the Charcot and control tendons were determined and the tendons were evaluated for differences in ultimate tensile strength and elasticity (Young’s modulus). Biomechanical test data show that there is a significant difference in ultimate tensile strength and elasticity between tendons of patients with Charcot’s foot and those of non-Charcot’s controls. The term diabetic tendo Achillis equinus is introduced as a new finding in diabetic neuroarthropathy. Full article

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Open AccessArticle

Foot Type and Overuse Injury in Triathletes

by Joshua Burns, Anne-Maree Keenan and Anthony Redmond

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 235-241; https://doi.org/10.7547/0950235 - 1 May 2005

Cited by 106 | Viewed by 49

Abstract

Abnormal foot morphology has been suggested to contribute to overuse injuries in athletes. This study investigated the relationship between foot type and injury incidence in a large sample of competitive triathletes not wearing foot orthoses during a 6-month retrospective analysis and a 10-week [...] Read more.

Abnormal foot morphology has been suggested to contribute to overuse injuries in athletes. This study investigated the relationship between foot type and injury incidence in a large sample of competitive triathletes not wearing foot orthoses during a 6-month retrospective analysis and a 10-week prospective cohort study. Foot alignment was measured using the Foot Posture Index and the Valgus Index, and participants were assigned to supinated, pronated, and normal foot-type groups. Overall, 131 triathletes sustained 155 injuries during the study. Generally, foot type was not a major risk factor for injury; however, there was a fourfold increased risk of overuse injury during the competition season in athletes with a supinated foot type. The results of this study show that triathletes with a supinated foot type are more likely to sustain an overuse injury. Full article

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Open AccessArticle

Cimetidine as a First-Line Therapy for Pedal Verruca. Eight-Year Retrospective Analysis

by Barry R. Mullen, John V. Guiliana and Fawaz Nesheiwat

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 229-234; https://doi.org/10.7547/0950229 - 1 May 2005

Cited by 8 | Viewed by 64

Abstract

Can cimetidine therapy effectively stimulate the body’s immune response against warts? Several clinicians have anecdotally reported success using cimetidine against warts. Previous double-blind studies comparing cimetidine with placebo therapy have failed to statistically and scientifically corroborate those results. Between 1995 and 2002, 216 [...] Read more.

Can cimetidine therapy effectively stimulate the body’s immune response against warts? Several clinicians have anecdotally reported success using cimetidine against warts. Previous double-blind studies comparing cimetidine with placebo therapy have failed to statistically and scientifically corroborate those results. Between 1995 and 2002, 216 patients underwent an isolated course of oral cimetidine therapy for verruca plantaris. Our treatment outcomes closely parallel those obtained by other researchers. Cimetidine may be used as a safe, effective, lone treatment modality for verruca in all age groups. Full article

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Open AccessArticle

Metatarsus Primus Elevatus in Hallux Rigidus. Fact or Fiction?

by Thomas S. Roukis

J. Am. Podiatr. Med. Assoc. 2005, 95(3), 221-228; https://doi.org/10.7547/0950221 - 1 May 2005

Cited by 54 | Viewed by 65

Abstract

Two hundred seventy-five lateral weightbearing radiographs of isolated pathology were reviewed and stratified into hallux rigidus (n = 100), hallux valgus (n = 75), plantar fasciitis (n = 50), and Morton’s neuroma (n = 50) groups. The patient population consisted of healthy individuals [...] Read more.

Two hundred seventy-five lateral weightbearing radiographs of isolated pathology were reviewed and stratified into hallux rigidus (n = 100), hallux valgus (n = 75), plantar fasciitis (n = 50), and Morton’s neuroma (n = 50) groups. The patient population consisted of healthy individuals with no history of foot trauma or surgery. The first to second metatarsal head elevation, Seiberg index, first to second sagittal intermetatarsal angle, first to fifth metatarsal head distance, and hallux equinus angle were measured in each population. Statistically significant differences were found between the hallux valgus, plantar fasciitis, and Morton’s neuroma populations and the hallux rigidus population, which showed greater elevation of the first metatarsal relative to the second for each radiographic measurement technique. In the hallux rigidus population, there was a statistically significant difference between grade II and grades I and III regarding the first to fifth metatarsal head distance (greater in grade II) and the hallux equinus angle (lower in grade II). A review of the literature and comparison with historical controls reveals that metatarsus primus elevatus exists in hallux rigidus and is greater than that found in hallux valgus, plantar fasciitis, and Morton’s neuroma groups. Full article

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J. Am. Podiatr. Med. Assoc., Volume 95, Issue 3 (05 2005) – 21 articles

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