Background: Clinical thermography is a relatively novel technique in wide use in different medical fields because of its versatility and ease of application. It inflicts no pain and it entails no contact with the pediatric patient, which assuages anxiety and fear in subjects when undergoing diagnostic exploration. The use of infrared clinical thermography being suggested here is to establish normality patterns, which have not been described in the relevant literature. These patterns may be extrapolated to pathological study by means of future research lines.
Methods: An observational, cross-sectional study (descriptive in nature) has been carried out, with a sample population of 328 children divided into two age groups; 6-7 and 13-16 years old, all of them schooled in the province of Cáceres (Spain). The variables analyzed here are: age, sex, and temperature. A FLIR E60bx® thermographic camera has been used to study foot temperature.
Results: Results show that the temperature varies among the different study areas established for the foot, although they remain constant bilaterally. In addition, the highest temperature is found to be located in the area of the first toe (29.8ºC), and the lowest at the heel (28.8ºC).
Conclusions: It can be concluded that both feet have the same thermal behavior, despite the variation in temperature among the different areas that were established in the foot for the purposes of this study.
Background: A variety of treatment modalities have been described for cutaneous warts. We sought to determine the safety and efficacy of a topical formulation of cantharidin, podophyllotoxin, and salicylic acid in the treatment of plantar warts. This combination treatment is widely used in Europe and elsewhere but has not been described in the podiatric medical literature.
Methods: A retrospective study was conducted of 144 patients with simple or mosaic plantar warts who were treated with a topical, pharmacy-compounded solution of cantharidin, 1%; podophyllotoxin, 5%; and salicylic acid, 30%. All of the patients, aged 8 to 52 years (mean ± SD, 20.9 ± 11.0 years), were treated according to the authors3 standard protocol. Of the 144 patients, 92 were being treated for the first time. None of the 52 previously treated patients had received more than one other type of treatment in the past.
Results: After 6 months of follow-up, complete eradication of the plantar warts was noted in 138 of the 144 patients (95.8%). Of these patients, 125 (86.8%) required a single application of the solution, and 13 (9.0%) needed two or more applications. No significant adverse effects or complications were observed.
Conclusion: A topical solution of cantharidin, podophyllotoxin, and salicylic acid was found to be safe and effective in the treatment of simple and mosaic plantar warts. This formulation is a promising alternative treatment modality for plantar warts. (J Am Podiatr Med Assoc 98(6): 445–450, 2008)
Background: The calcaneus is the bone of the foot that first receives the impact of running, generating vibrations that might have a positive effect in modifying the trabecular bone mass. The objective of this study was to determine the variation in calcaneal bone density in runners during a 6-month training season, comparing it with a control sample.
Methods: Bone density of the heel was measured in 33 male recreational runners by means of a contact ultrasonic bone analyzer. Measurements were made on three occasions during a training season: at the beginning, at 350 km, and at 700 km. All of the runners wore the same model of running shoes during this period. Measurements of bone density were also made in a control sample of 62 men who did not engage in physical exercise.
Results: There was a significant decrease in mean calcaneal bone density over the course of the training season (from 86.1 dB/MHz to 83.2 dB/MHz; P = .006), but no significant differences with the control sample value (from 80.7 dB/MHz to 81.1 dB/MHz; P = .314). The runners' body composition changed during the study period, with lean mass increasing and fat mass decreasing.
Conclusions: Distance running seems to have a negative effect on calcaneal bone mass density during the course of a 700-km training season.
We sought to determine a predictive model of data, differentiated by sex, from a radiographic study of the skeleton of the foot as an alternative to the classic study of the hand.
The study included 2,476 digital radiographs from 816 participants aged 0 to 21 years. The radiographs were from the Radiology Diagnostic Services of the Public Health System of Extremadura (Spain) from 2007 to 2011. The method used for their analysis consisted of assigning a numerical code to each ossification center of each growing bone of the foot and subsequently subjecting the data to a multivariate, decision tree, statistical analysis.
The decision tree study identified the bones that have a common age-dependent pattern of growth (as determined by a comparison of means test with P < .01) among individuals of the same sex. The quality of the decision tree predictions was evaluated in terms of the r coefficient. These values were r2 = 0.897 for females and r2 = 0.890 for males, thus establishing the predictive goodness of the model of bone data to provide a specific estimate of the individual's age.
The foot is a good predictor of an individual's age from birth to complete bone maturity.
Fatigue due to running has been shown to contribute to changes in plantar pressure distribution. However, little is known about changes in foot posture after running. We sought to compare the Foot Posture Index before and after moderate exercise and to relate any changes to plantar pressure patterns.
A baropodometric evaluation was made, using the FootScan platform (RSscan International, Olen, Belgium), of 30 men who were regular runners and their foot posture was examined using the Foot Posture Index before and after a 60-min continuous run at a moderate pace (3.3 m/sec).
Foot posture showed a tendency toward pronation after the 60-min run, gaining 2 points in the Foot Posture Index. The total support and medial heel contact areas increased, as did pressures under the second metatarsal head and medial heel.
Continuous running at a moderate speed (3.3 m/sec) induced changes in heel strike related to enhanced pronation posture, indicative of greater stress on that zone after physical activity. This observation may help us understand the functioning of the foot, prevent injuries, and design effective plantar orthoses in sport. (J Am Podiatr Med Assoc 103(2): 121–125, 2013)
The Foot Posture Index (FPI) quantifies foot posture on the basis of six criteria. Although the male foot is longer and broader than the female foot, limited evidence exists about the differences in foot posture between the sexes and which are its biological and anthropometric determinants. We sought to evaluate possible sex differences in the FPI and the determinants influencing foot posture.
In 400 individuals (201 men and 199 women), the FPI was determined in the static bipedal stance and relaxed position. The FPI was obtained as the sum of the scores (−2, −1, 0, 1, or 2) given to each of six criteria. A multiple regression model was constructed of the overall FPI against age, weight, height, body mass index, and foot size.
The mean ± SD FPI was 2.0 ± 4.3 overall, 1.6 ± 4.5 for men, and 2.4 ± 4.1 for women, with the difference being nonsignificant (P = .142). The neutral posture was the most frequent (57.3%). A greater proportion of women had neutral and pronated feet, and a greater proportion of men had supinated and highly supinated feet, with the differences being nonsignificant (P = .143). Foot size, height, and body mass index together explained 10.1% of the overall FPI value (P < .001).
The most frequent posture was neutral with a certain degree of pronation, with no differences in FPI values between men and women. Participants with larger foot sizes had higher FPI values, whereas taller and heavier participants had lower FPI values. (J Am Podiatr Med Assoc 103(5): 400–404, 2013)