Archive for Woundcare
Charcot Foot
Posted by: | CommentsCharcot-Marie-Tooth disease (CMT) is one of the most common inherited neurological disorders, affecting approximately 1 in 2,500 people in the United States. The disease is named for the three physicians who first identified it in 1886 – Jean-Martin Charcot and Pierre Marie in Paris, France, and Howard Henry Tooth in Cambridge, England. CMT, also known as hereditary motor and sensory neuropathy (HMSN) or peroneal muscular atrophy, comprises a group of disorders that affect peripheral nerves. The peripheral nerves lie outside the brain and spinal cord and supply the muscles and sensory organs in the limbs. Disorders that affect the peripheral nerves are called peripheral neuropathies.
The neuropathy of CMT affects both motor and sensory nerves. (Motor nerves cause muscles to contract and control voluntary muscle activity such as speaking, walking, breathing, and swallowing.) A typical feature includes weakness of the foot and lower leg muscles, which may result in foot drop and a high-stepped gait with frequent tripping or falls. Foot deformities, such as high arches and hammertoes (a condition in which the middle joint of a toe bends upwards) are also characteristic due to weakness of the small muscles in the feet. In addition, the lower legs may take on an “inverted champagne bottle” appearance due to the loss of muscle bulk. Later in the disease, weakness and muscle atrophy may occur in the hands, resulting in difficulty with carrying out fine motor skills (the coordination of small movements usually in the fingers, hands, wrists, feet, and tongue).
Onset of symptoms is most often in adolescence or early adulthood, but some individuals develop symptoms in mid-adulthood. The severity of symptoms varies greatly among individuals and even among family members with the disease. Progression of symptoms is gradual. Pain can range from mild to severe, and some people may need to rely on foot or leg braces or other orthopedic devices to maintain mobility. Although in rare cases, individuals may have respiratory muscle weakness, CMT is not considered a fatal disease and people with most forms of CMT have a normal life expectancy.
Abscess in the Foot
Posted by: | CommentsAs a podiatrist, I see many unusual things. Diabetics who have stepped on a sewing needle and not realized it, puncture wounds from thorns that went through a hunting boot and holes completely through a foot due to a misguided pressure washer! All of these injuries require the removal of a foreign body but they also have the potential to lead to an abscess. In fact, any break in the skin can lead to an abscess.
An Abscess is a collection of pus under the skin. Abscesses are considered localized infections that can cause pain and illness. An abscess can initiate the growth of aggressive infections to other parts of the body. When an abscess develops on the foot, the area involved may become red, hot, swollen, and tender. This infection can spread and ultimately affect other tissues in the foot and leg. When abscesses become large and go untreated, the infection can spread to the bone and lead to a bone infection (osteomyelitis). Once the bone becomes infected, more extensive surgery may be necessary to resolve the infection.
Abscesses can be caused by many factors. Patients that have depressed immune systems are much more at risk for developing an abscess. Diabetes is an example of a disease where one’s immune system is compromised. Often times, a small break in the skin or a blister can start the formation of an abscess. Poor hygiene can also contribute to abscess development and must be addressed during the course of any treatment. Abscesses can form on the feet and can be extremely painful. Abscesses tend to grow in warm moist places, and therefore, the foot is a frequent site for this condition. Trauma is another cause of abscess formation. When direct injury occurs to the foot or any part of the body resulting in a break in the skin, a pathway for infection is created.
Abscesses can be treated conservatively or surgically depending on the extent of the abscess formation. Initially, the treatment should consist of rest and staying off of the affected limb or body part. Warm soaks and moist heat can help alleviate the pain associated with abscess formation. Antibiotics are usually given to the patient to fight off the infection. However, depending upon the extent of the abscess and the organism involved, oral antibiotics may not be enough to fight off the infection. Drainage of the abscess may be warranted if the infection does not resolve. If the abscess is surgically treated IV or oral antibiotics may be administered. After the abscess heals or during the healing process itself, the wound should be kept clean and close monitoring of the condition should be performed.
As you can see, an abscess can be a very serious condition and should be evaluated and treated by a physician. Podiatrists are trained to handle injuries and infections of the foot and are an excellent choice when dealing with an abscess, or potential abscess.
