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Plantar Fasciitis
A Degenerative Process (Fasciosis) Without Inflammation
The authors review histologic findings from 50 cases of heel spur surgery for chronic plantar fasciitis. Findings include myxoid degeneration with fragmentation and degeneration of the plantar fascia and bone marrow vascular ectasia. Histologic findings are presented to support the thesis that “plantar fasciitis” is a degenerative fasciosis without inflammation, not a fasciitis. These findings suggest that treatment regimens such as serial corticosteroid injections into the plantar fascia should be reevaluated in the absence of inflammation and in light of their potential to induce plantar fascial rupture. (J Am Podiatr Med Assoc 93(3): 234-237, 2003)
Infant Heel Nodules
Calcification of Epidermal Cysts
Calcified nodules of the heel have been reported in high-risk neonates following multiple needle sticks to draw blood. Previous reports suggest that the needle stick trauma causes dystrophic calcification. A case of multiple discrete firm heel lesions, which began shortly after birth in an immature-birth weight neonate who had sustained multiple needle sticks of the heel, is presented. Histologically, these lesions demonstrated foci of calcification and fragments of keratin surrounded by an epithelial lining, suggesting that calcified nodules may also arise from epidermal implantation cysts that secondarily calcify. (J Am Podiatr Med Assoc 92(2): 112-113, 2002)
The medical literature reveals numerous reports of transient taste disturbance associated with the use of oral terbinafine. A review of these reports, however, fails to confirm taste disturbances by formal taste testing. In this article, a case of long-standing taste dysfunction in a patient who exhibited normal formal taste thresholds is described. (J Am Podiatr Med Assoc 91(10): 540-541, 2001)
A case of tophaceous gout involving a foot sesamoid is described in a middle-aged man with a history of chronic gout. Microscopic findings consisting of tophaceous foci located beneath an intact hyaline articulating surface are correlated with associated radiographs. (J Am Podiatr Med Assoc 91(7): 379-380, 2001)
