learn two Podiatry tenets that become incontravertibly edged in my clinical mind, Deadline: April 15th, 2008

Diagnostic ultrasound is a great way to differentiate between calcaneal fat pat injuries and plantar fasciitis.
Diagnostic ultrasound will also pick up plantar fibromas too.

1.) It is best to let the unit warm-up for 5 minutes before using.
2.) I must remember to keep the blue dot on the applicator either to my left, or the patients head. This keeps the orientation lined up on the display screen.

I’m at a practice mgmt seminar in the Glendale, AZ area since Thursday:
1.) If a new patient keeps your receptionist on the phone longer than four minutes, the chances of them scheduling an appt are actually very small.
2.) Getting a JCAHO accreditation is a great competitive advantage.

To allow six months to elapse before undertaking any elective (i.e. foot) surgery on a patient anytime a heart attack, cancer treatment, or other life-threatening episodes.

You need six months of documented conservative care befcre you can employ shock wave therapy for heels. This is mainly mandated by the insurance companies.

Psoriasis:
1.) A skin biopsy is often called for to rule out other diagnoses (particularly fungal ones). There is no skin test specifically for psoriasis.
2.) UV radiation, or phototherapy, is the second line of treatment if topical steroids fails to cure the acute stage.

1.) The feet have 250,000 sweat glands. A plugged sweat gland will result in an intractable plantar keratosis.
2.) In much the same way that cooling the blade with a moist gauze in surgery will help prevent “smoking bone”, cooling the saw blade when removing a cast will help prevent the heat discomfort that some patients feel when having their cast removed.

1.) Place the mayo stand on the opposite side of the limb you’re working on.
2.) Have four blades on the table at all time. Have your assistant change blades immediately after making the skin incision.
3.) Before doing your fixation, ensure that the tibial sessamoid is directly under the head of the first met. If it isnt, move the head more laterally, or free up the sesamoids more.
4.) Use a Sayre elevator between the head and the sessamoids to prepare for shaving of the medial eminence.

1.) Diabetes becomes uncontrolled with 2-3 consecutive blood sugar readings greater than 250 mg/dl, or an HgA1c reading over 7.0. Uncontrolled diabetics are at a much higher risk for heart disease, kidney, eye, and nerve problems.

2.) HgA1c corresponds to a patients average blood sugar amount over the past two months. The lower the number, the better the control. Too bad they dont have drug testing that shows a patients average drug levels over the past three months, eh?

1.) Adding a metatarsal pad to a custom orthotic dramatically relieves metatarsal pain pressures and pain (the area right under your toe heads on the bottom of your foot.)
2.) Treating functional hallux limitus (stiffness of the great toe) works with an orthotic. Structural hallux limitus does not respond to orthotics.
3.) Functional hallux limitus is described as anything less than twelve degrees of hallux dorsiflexion, and 100% of patients studied achieved an increase in this dorsiflexion simply by wearing orthotics.
4.) Tarsal Tunnel bonus: A great diagnostic test for TIS is to dorsiflex all MPJ”s and hold the foot in max dorsiflexion and eversion for 5-10 seconds and see if you get an excacerbation of symptoms

1.) Botox injections on the foot are now gaining favor after the success of axillary injections to stop underarm wetness.
2.) The dryness in the feet tends to only last a couple months, at which point, more botox injections would be needed.
3.) 50 injections, at the bottom of the foot, with a 30gauge needle would need to be performed.
4.) Conservative measures include domeborro foot soaks, and topical anti-perspirants.
5.) Botox injections are preferrable to symphectomy because in the latter case, the body tends to make up for the sweating in other areas of the body. (or compensatory hyperhydrosis to put it in medical nerdspeak)