DEFINITIONS WITH PICTURES

Achilles Tendon Rupture

The Achilles Tendon is the heel cord in the back of the heel. Achilles tendons can rupture for many reasons, including age, sex (males are more susceptible), and sports. However, the Achilles Tendon may also rupture secondary to medical negligence – e.g., giving cortisone injections into the Achilles Tendon.

Amputation

Amputations are the loss of a body part. Amputations are divided into Traumatic Amputations (those involving loss of a body part caused by an injury) and Non-traumatic Amputations. The later often occurs secondary to diabetes, poor circulation, or infection.

Baxter’s Nerve Entrapment

Baxter’s nerve entrapment is a difficult clinical diagnosis and often overlooked in the presentation of heel pain. It can produce symptoms indistinguishable from plantar fasciitis and other causes of heel pain. Of note is that this nerve is often injured when surgery for heel spurs or plantar fasciitis is performed, which can result in severe pain and tingling sensations.

Bunion

A bunion is a common term for a medical condition known as Hallux Valgus. Hallux Valgus if the tilting of the toe away from the mid-line of the body. It is usually characterized by a lump or bump that is red, swollen and/or painful on the inside of the foot in and around the big toe joint. There are many causes of bunions, but the primary one is tight, ill-fitting shoes, shoes that constrict the forefoot over a long period of time. High heels and constricting forefoot shoe gear are the primary causes of Hallux Valgus.

Complex Regional Pain Syndrome (CRPS)

CRPS is a severe and debilitating condition that occurs when the nerves in the leg “go haywire.” A small traumatic injury such as a slip and fall or any other type of foot, ankle, or leg surgery can ignite this complication. Early and aggressive treatment usually results in complete remission of the symptoms. However, if the diagnosis is not promptly made, or if it is not treated in a timely manner, then the disorder can become severe, debilitating, and often leads to permanent disability.

Cosmetic Foot Surgery

Surgery undertaken solely to for the purpose of affecting the appearance or the size of the foot (e.g., to make the foot smaller to be able to fit into smaller/stylish shoes).

Diabetes: Diabetes is probably the most damaging disease that a patient can encounter with regards to their feet. Diabetes comes in two basic types; type 1 and type 2. Type 1 is usually associated with juvenile diabetes and is usually a hereditary type of disease. Type 2, commonly referred to as adult onset diabetes, is usually characterized by elevated blood sugars by people who are overweight and have not attended to their diet as they should.

Extracorporal Shock Wave Therapy (ESWT)

ESWT is an emerging new therapy for the treatment of chronic heel pain.

Foot Ulcers

Foot ulcers are generally a breakdown of the skin on the plantar aspect (bottom) of the foot. They have many causes, but the most common are diabetes, and vascular insufficiency. Diabetes or vascular insufficiency should be taken very seriously as a good warning sign of impending loss of limb.

Fungus Nails

Fungus nails are thickened, deformed, and often painful toenails that are caused by an infection of fungus. The fungus infects the nail, decays it, and causes the nail to become thick.

Gangrene: Dry Gangrene

More common in people with diabetes and autoimmune diseases, dry gangrene usually affects the hands and feet. It develops when blood flow to the affected area is impaired, usually as a result of poor circulation. Wet gangrene almost always involves an infection. Injury from burns or trauma where a body part is crushed or squeezed can rapidly cut off blood supply to the affected area, causing tissue death and increased risk of infection. Gas gangrene: Gas gangrene occurs when infection develops deep inside the body, such as inside muscles or organs. The bacteria releases dangerous toxins or poisons that, along with gas, destroys body tissues.

Haglund’s Deformity

Haglund’s Deformity is a condition of pain and discomfort on the posterior (back) aspect of the heel at the area of the insertion of the Achilles tendon.

Hammertoes / Bone Spurs

Hammertoes, exostosis (bone spurs) could also be grouped under arthritis. Hammertoes, bone spurs, and exostosis are all a result of an imbalance of the muscle structures of the toes, when the toes become crooked, bent, or buckle under causing joints to protrude. These are all descriptions of a biomechanical imbalance.

Ingrown Nails / Fungus Nails

An ingrown toenail is a condition in which the nail is cutting into the flesh. This condition is usually very painful and is usually associated with infection of the toe. A nail is ingrown when one or both corners or sides of the nail grow into the skin of the toe. Irritation, redness, uncomfortable sensation of warmth, as well as swelling, pain and infection can result from an ingrown toenail.

Metatarsal Problems / Callus / IPK

In severe cases of calluses, which usually occur on the plantar aspect (bottom) of the foot, an IPK can develop. An IPK is, in medical terminology, an Intractable, meaning that it will not go away, Plantar, meaning bottom of the foot, Keratosis, meaning a deep seated painful callus that usually occurs under a weight bearing metatarsal (long bone of the foot).

NSAID – Non-steroidal anti-inflammatory drug

They are called nonsteroidal because they are not steroids, which treat inflammation by suppressing the immune system (inflammation is one of the body’s healing responses to trauma). Instead, all NSAIDs treat inflammation in a way similar to the mechanism of aspirin, the most well-known and oldest member of the class.

Non-Union

Non-union refers to the failure of a bone to “knit” back together following a fracture or surgery. There are many causes of non- union. Non-unions can develop as a result of medical negligence in some instances, such as allowing the patient to walk on the foot too soon.

Osteomyelitis

Osteomyelitis is an infection involving a bone. The condition is serious because treatment often requires several weeks of intra-venous treatment with potent antibiotics and often involves surgery on the affected bone.

Reflex Sympathetic Dystrophy

See Complex Regional Pain Syndrome (above).

Shin Splints: A shin splint is technically the tearing away of the anterior tibial muscle from the bone. Shin splints, or tenosynovitis of the anterior tibial muscle (the muscle that runs from the mid portion of the foot up the front of the leg, just below the knee, on the inside front of the calf) is usually caused by over-use. Beginning runners or other people who engage in sport activities who have not sufficiently allowed their muscle tone to build up over a proper conditioning program, or whose conditioning program is too rigorous in the beginning, develop shin splints. However, people with biomechanical, excessive pronation or supination of the foot also develop shin splints.

Subungual (Under Toenail) Melanoma

Subungual Melanoma is a serious type of skin cancer that occurs in the skin under your nails.

Tailor’s Bunion or Bunionette

A tailor’s bunion, also known as a bunionette, is a bump or prominence on your fifth metatarsal bone, at the base of your small 5th toe. Tailor’s bunions are not really a growth of bone or a calcium deposit. It is the rounded end of the fifth metatarsal bone spreading outward from the center of your body. Painful symptoms often occur due to constricting shoes more commonly worn by women.

Warts

Warts, or Verruca(e) are small, grainy skin growths that occur most often on your feet and hands. These are rough to the touch and resemble cauliflower. They can feature a pattern of tiny black dots — sometimes called seeds — which are small, clotted blood vessels. Despite the fact that warts are generally caused by a virus and can be treated, these can be mistaken for foot melanomas and in those cases, can be deadly. See out recent case report as to the negligent diagnosis.