Part III Foot Disorders And Ailments

Ganglion Cyst

Although ganglion cyst are normally found on the wrist or the dorsal portion of the hand, they are often form on the dorsal portion of the foot, as well. The ganglion cyst is an oval sac that is filled with a jellylike fluid. It derives from a tendon or joint capsule and has the appearance of a knot-like lump.

  • Treatment begins with monitoring the cyst to see if it continues to increase in size. If the condition continues to be asymptomatic, no treatment will be required, but if it begins to interfere with joint movement, aspiration may be ordered. Of course, the ganglion may need to be surgically removed, if it continues to grow and cause movement issues.

Equinus

Equinus is a deformity of the Achilles Tendon, which is shorter than what is required for dorsiflexion (moving toes and foot, upward toward the knees). This can cause the individual to have an abnormal gait and mobility imbalance. There are two different types of equinus spastic and non-spastic.

  • Causes of spastic equinus may be linked to neuromuscular diseases including cerebral palsy. Non-spastic equinus is a hereditary condition, where the Achilles Tendon is shorther than normal.
  • Complications may be flatfoot deformity and the inability to dorsiflex the foot.
  • Treatment may include surgery in more severe cases.

Foot Drop

Foot drop (peroneal nerve injury) is characterized by the difficulty or inability to lift the front portion of the foot up, when ambulating or flexing.

  • Causes are linked to stroke, trauma to the common fibular nerve, ankle weakness, and paralysis.
  • Treatment may range from braces, physical therapy, orthotics, or surgery, in more severe cases.

Toenail Fungus

Toenail fungus (onychomycosis) is the abnormal yellowing of the toenail. The fungus will eventually grow deeper into the nail bed, when this occurs the toenail will become cracked and crumble at the edges. This is the same dermatophyte fungus that causes athlete’s foot condition.

  • Treatment may begin with an over the counter anti-fungal medication including Penlac, which is a medicated nail polish. In more severe cases the Avulsion procedure (removal of the toenail) may be required. Technology has come a long way, when it comes to medical treatments. The laser therapy is very expensive, but effective in treating toenail fungus.
  • Complications may occur, if the fungus goes untreated. The fungus can spread to the nearby skin tissue and the toenail can become very thick and painful.

Gout

Gout is a form of arthritis that normally affects the big toe. It will eventually spread to the ankles and wrists if untreated. Of course, the pain is so severe, it is very difficult to ignore this condition.

  • Causes are linked to high levels of uric acid and the buildup of urate crystals in the joints. Uric acid is produced, when the body breaks down purines, which are found in red, organ meats, alcoholic beverages, fructose and seafood. Urate crystals are needle-like crystal formations that can cause a gout attack.
  • Symptoms include severe joint pain, inflammation and redness at the joint, and limited ROM (range of motion).
  • Diagnosis may begin with an x-ray or an ultrasound. Laboratory tests include uric acid levels, BMP, CBC, and synovial fluid analysis (aspiration fluids from affected joint).
  • Treatment is usually prescribed in the form of oral medications including xanthine oxidase inhibitors (block uric acid production) Uloric and Lopurin. NSAIDs (Advil, Motrin), Celebrex, Indocin. Colchicine is very commonly prescribed, because it is very effective in reducing gout pain.
  • Complications range from recurrent gout attacks, advanced gout (spread to other joints), and kidney stones. It is vital that you seek medical treatment, if you begin to experience the signs and symptoms of gout.

Haglund’s Deformity

Haglund’s deformity is an abnormal bony enlargement found on the posterior portion of the calcaneus (heel).

  • Causes are linked to wearing high heeled shoes, skates, dress shoes, but any shoe that has an extremely rigid back can be the culprit of this condition. This disorder can also be linked to hereditary foot abnormalities.
  • Inherited conditions range from a high arch, tight Achilles Tendon, and stepping on the lateral portion of the calcaneus.
  • Symptoms include bump, edema, and inflammation on the posterior calcaneus, and pain near the area, where the Achilles Tendon and calcaneus meet.
  • Complications if condition goes untreated is bursitis, which inflammation of the bursa. The bursa (fluid-filled sac) is located between the tendon and bone.
  • Treatment includes orthotics, physical therapy, exercises, stretching, and NSAID’s (Motrin, Advil). Surgery is rarely used, as a form of treatment, but only if all other treatments fail.

To see the foot anatomy please click here.