Rickets is a pediatric disorder not commonly encountered by physicians in the US. Nevertheless, the podiatric physician should be aware that it persists and may exist in children who initially present with gait disturbances or failure to thrive. By using routine plain film radiography of the child's foot, the podiatric physician can screen one of the child's most rapid sites of secondary osseous growth, ie, the distal tibia. A brief overview of the rachitic and osteomalacic disorders is presented, followed by a discussion centered primarily on the plain film radiologic diagnosis of rickets.
Peripheral skeletal infections caused by Mycobacterium are widely reported in the literature. Unfamiliarity with this disease, or oversight caused by inexperience may result in failure to thoroughly investigate the presence of this organism. An unusual case of tuberculous osteomyelitis involving the second digit of the foot is presented. The authors emphasize the importance of including cultures of acid-fast bacillus in the work-up of atypical infectious processes of the foot and ankle, and include Mycobacterium in their differential until it is positively ruled out. An in-depth radiologic review is included.
A middle-aged man presented for left foot diabetic ulcer care. Pedal radiographs were negative for signs of osteomyelitis. However, asymptomatic incidental osseous findings demonstrated significant plantar and posterior calcaneal spurring possibly consistent with diffuse idiopathic skeletal hyperostosis (DISH). A differential of DISH, psoriatic arthritis, Reiter’s, and ankylosing spondylitis was developed. Subsequent spinal imaging and laboratory work-up did not satisfy the diagnostic criteria for DISH. This case illustrates radiographic changes characteristic of multiple seronegative arthropathies. On initial presentation a diagnosis of DISH was most likely, but with further imaging studies a diagnosis of a variant of psoriatic arthritis may be more correct. (J Am Podiatr Med Assoc 102 (5): 422-427, 2012)
We developed a prototype of a novel thermochromic liquid crystal (TLC)–coated fabric with an extended temperature range and enhanced sensitivity. By incorporating color and pattern recognition into the fabric, rapid determination of the underlying pedal temperature is facilitated. The purpose of this study was to evaluate the accuracy of the TLC fabric as a potential diagnostic aid for identifying complications in the high-risk foot.
The hands of 100 individuals were used to compare the mean maximum temperatures indicated by the fabric versus standard thermal camera images. Findings were statistically analyzed using a paired t test, with significance defined as P < .05.
Except for the tip of the thumb and regions in the palm, there were no statistically significant differences between mean maximum temperatures measured with the thermal camera and those detected with the TLC fabric. Minor differences were relatively consistent in all nine regions of the hand and were not considered to be clinically significant.
Using direct visual analysis, we demonstrated that a novel TLC fabric could accurately map temperatures in the palmar surface of the hand. The findings support the continued development of a temperature-sensitive sock that can be used in the home to monitor for temperature changes that may indicate the onset of complications in the high-risk foot.