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This study was designed to determine the prevalence of fibromyalgia in the podiatric patient population. A total of 355 consecutive patients in a podiatric outpatient clinic were evaluated to determine whether they met the criteria for this condition. Eight of the 355 patients were diagnosed with the condition. Thirty-five of 355 patients presented with plantar heel or arch pain. Seven of these 35 patients satisfied the criteria for fibromyalgia. This small study indicates that fibromyalgia may be more prevalent in podiatric patients than previously realized and must be considered in patients presenting with foot pain, especially if that pain is in the area of the plantar aspect of the heel or arch.
Electrical debridement of nails results in hazardous airborne particles. This study compares the effectiveness of several nail dust extractors in reducing the amount of this debris. All extractors were more effective than the control, with a minimum of 24.6% effectiveness to a maximum of 91.6%.
The author has developed a technique of dilute anesthetic ankle block that appears, on the basis of these preliminary observations, to relieve pathologic pain that may be maintained by the sympathetic nervous system. Symptomatic relief following the use of this injection confirms that the patient's problem is not somatic and that further evaluation and treatment of sympathetically maintained pain syndrome may be indicated.
A study was conducted to determine whether fungal culture results in cases of suspected onychomycosis differ depending on the location from which the specimen is obtained. Specimens were taken from the nail plate, subungual debris, and nail bed in 30 patients with clinical evidence of onychomycosis. Cultures from the subungual debris were more likely to be positive for dermatophytes, nondermatophytic molds, and yeasts than were cultures from the deeper nail bed or nail plate.
Fibromyalgia presents with generalized body pain, multiple tender points, and associated ancillary symptoms, including fatigue and nonrestorative sleep. The abnormal sleep pattern is the most common accepted etiology for this condition. The diagnosis may be made on the basis of a classic presentation of symptoms and clinical findings. The treatment of fibromyalgia includes aerobic exercise and the use of tricyclic antidepressants to modulate the sleep disorder with less than excellent results. In spite of the frustrations in treating this condition successfully, many patients are relieved to be provided with a diagnosis and to obtain sympathetic and supportive care from their physicians.
Chondrosarcomas have been seen clinically as aggressive tumors, with radiographic and histologic findings consistent with malignancy; however, they may have an insidious clinical course, with relatively benign radiographic and histopathologic findings. Rarely, a chondrosarcoma may present as a primary lesion of the foot. It is important to recognize these lesions as malignancies. The authors provide an overview of these neoplasms and describe a case of a low-grade chondrosarcoma in a 64-year-old woman.