• Title/Summary/Keyword: Clinical foot diagnosis

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Malignant Melanoma of the Foot (족부의 악성 흑색종)

  • Moon, Sung-Hoon;Park, Hong-Gi
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.18-23
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    • 2006
  • Purpose: We reviewed the clinical finding of malignant melanoma of the foot in korean because it's advanced stage and extended lesion at diagnosis. Materials and Methods: Retrospective study was enforced about the 11 cases who has diagnosed to malignant melanoma of the foot from February 1995 to March 2004. The mean follow up period was 61 months. In this study we used age, sex, site, depth, histology, clinical stage, precursor lesion, misdiagnosis, interval to diagnosis, survival time, survival. Results: Average age was 58 years and number of female was six. Common site of involvement were heel of plantar surface (6 cases) and subungual area (2 cases). Depths of involvement were 0.3 to 10 mm, most common histological type was acral lentiginous melanoma (7 cases), stage 5 according to classification of Clark were 5 cases and stage 2 or more according to clinical staging were 8 cases. precursor lesion were benign melanocytic nevi (2 cases) and ill defined (9 cases). Chief complaint were increasing of size, color change, pain and ulceration. Conclusion: Malignant melanoma of the foot usually arise at nonvisible area and is easy to be misdiagnosed or delayed treatment. So it is hard to early diagnosis and have poor prognosis. So we need education and effort to early detection and diagnosis.

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Acute Compartment Syndrome of the Lower Leg and Foot (하지와 족부의 급성 구획 증후군)

  • Chae, Soo Uk
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.3
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    • pp.165-173
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    • 2013
  • Acute compartment syndrome of the lower leg and foot is a surgical emergency. The clinical symptoms is an important clue to diagnose compartment syndrome. In cases of ambiguous diagnosis, unconscious patients and children additionally need a intracompartmental pressure measuring. Immediate fasciotomy should be performed when clinical signs are obvious or when delta pressure is less than 30 mmHg or intracompartmental pressure is greater than 30 mmHg. Fasciotomy of the lower leg can be performed either by one lateral single incision or double incision, which of the foot mainly has a dorsal or medial incision. A delayed in diagnosis that leads to a delay in treatment can result in devastating disability. Acute compartment syndrome of the lower leg and foot is a relative rare but serious complication of which a surgeon should be aware.

Podiatric Clinical Diagnosis using Decision Tree Data Mining (결정트리 데이터마이닝을 이용한 족부 임상 진단)

  • Kim, Jin-Ho;Park, In-Sik;Kim, Bong-Ok;Yang, Yoon-Seok;Won, Yong-Gwan;Kim, Jung-Ja
    • Journal of the Institute of Electronics Engineers of Korea CI
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    • v.48 no.2
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    • pp.28-37
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    • 2011
  • With growing concerns about healthy life recently, although the podiatry which deals with the whole area for diagnosis, treatment of foot and leg, and prevention has been widely interested, research in our country is not active. Also, because most of the previous researches in data analysis performed the quantitative approaches, the reasonable level of reliability for clinical application could not be guaranteed. Clinical data mining utilizes various data mining analysis methods for clinical data, which provides decision support for expert's diagnosis and treatment for the patients. Because the decision tree can provide good explanation and description for the analysis procedure and is easy to interpret the results, it is simple to apply for clinical problems. This study investigate rules of item of diagnosis in disease types for adapting decision tree after collecting diagnosed data patients who are 2620 feet of 1310(males:633, females:677) in shoes clinic (department of rehabilitation medicine, Chungnam National University Hospital). and we classified 15 foot diseases followed factor of 22 foot diseases, which investigated diagnosis of 64 rules. Also, we analyzed and compared correlation relationship of characteristic of disease and factor in types through made decision tree from 5 class types(infants, child, adolescent, adult, total). Investigated results can be used qualitative and useful knowledge for clinical expert`s, also can be used tool for taking effective and accurate diagnosis.

Diagnosis of Morton's Neuroma Using MR Imaging scans (지간 신경종의 자기 공명 영상을 이용한 진단)

  • Hong, Ki-Do;Ha, Sung-Sik;Sim, Jae-Cheon;Kim, Jae-Young
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.1
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    • pp.131-134
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    • 2003
  • Most interdigital neuroma can be diagnosed clinically. But, diagnostic local injection method, sonography and magnetic resonance image(MRI) have been used as secondary tests for clinical confirmation or surgery. Recently, there have been active discussions on the method of interdigital neuroma diagnosis for which sonography or MRI is used. For finding out the location or the number of interdigital neuroma particularly in non-typical clinical manifestation or surgery, MRIs, which are exellent in tissue contrast, may be quite helpful. This case had an interdigital neuroma showing non-typical manifestation. MRIs were used for clinical diagnostic confirmation and finding out the location and the number of interdigital neuroma. Thus, the validity along with literary consideration is being reported.

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Controversies on the Usefulness of Nerve Conduction Study in the Early Diagnosis of Diabetic Polyneuropathy: Cons (당뇨병성 다발신경병증의 조기 진단에 있어서 신경전도검사의 유용성에 관한 논란: 부정적인 관점에서)

  • Sohn, Eun Hee
    • Annals of Clinical Neurophysiology
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    • v.10 no.1
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    • pp.33-37
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    • 2008
  • Diabetic polyneuropathy (DPN) is the most common form of diabetic neuropathy, and causes a significant morbidity with an impact on the quality of life in the patients with diabetes. Since DPN frequently induces foot deformity and ulceration, which finally leads to foot amputation, the early detection and treatment is very important for the prevention of a permanent structural change. In the early stage of DPN, the diagnostic methods which can evaluate the function or structure of small nerve fibers should be employed because small nerve fibers are first involved in the course of DPN. However, the nerve conduction study cannot reflect the function of the small nerve fibers, and thus, has a definite limitation in the early diagnosis of DPN. For the early detection of DPN, electrodiagnostic data should be interpreted on a clinical context, along with the careful evaluation of the small nerve fiber functions using the tests such as the analysis of intraepidermal nerve fiber density.

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Diagnosis and Treatment of Cavus Foot (요족의 진단과 치료)

  • Suh, Jae Wan;Choi, Woo Jin;Lee, Jin Woo
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.2
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    • pp.55-61
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    • 2016
  • The cavus foot is a deformity characterized by an elevated medial longitudinal arch and a hindfoot varus with plantarflexed 1st ray. The etiology of cavus foot is usually related to neuromuscular disease or idiopathic cause. Thorough clinical and radiographic evaluation is required for differentiating etiology of the cavus. Most cases of cavus foot are stable and slowly progressive deformities which can initially be managed with conservative treatment including orthoses and physical therapies. Determining whether the deformity is flexible or rigid, the apex of the deformity and any muscle imbalances in foot and ankle is important for achievement of an adequately balanced plantigrade foot. Treatment should include systematic preoperative planning for selection of appropriate procedures for maintaining a functional and flexible foot with combinations of soft-tissue release, osteotomy, tendon transfer, and arthrodesis.

Clinical Characteristics of Peroneal Nerve Palsy by Posture

  • Yu, Jeong Keun;Yang, Jin Seo;Kang, Suk-Hyung;Cho, Yong-Jun
    • Journal of Korean Neurosurgical Society
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    • v.53 no.5
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    • pp.269-273
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    • 2013
  • Objective : Posture induced common peroneal nerve (CPN) palsy is usually produced during the prolonged squatting or habitual leg crossing while seated, especially in Asian culture and is manifested by the onset of foot drop. Because of its similarity to discogenic foot drop, patients may be diagnosed with a lumbar disc disorder, and in some patients, surgeons may perform unnecessary examinations and even spine surgery. The purpose of our study is to establish the clinical characteristics and diagnostic assessment of posture induced CPN palsy. Methods : From June 2008 to June 2012, a retrospective study was performed on 26 patients diagnosed with peroneal nerve palsy in neurophysiologic study among patients experiencing foot drop after maintaining a certain posture for a long time. Results : The inducing postures were squatting (14 patients), sitting cross-legged (6 patients), lying down (4 patients), walking and driving. The mean prolonged neural injury time was 124.2 minutes. The most common clinical presentation was foot drop and the most affected sensory area was dorsum of the foot with tingling sensation (14 patients), numbness (8 patients), and burning sensation (4 patients). The clinical improvement began after a mean 6 weeks, which is not related to neural injury times. Electrophysiology evaluation was performed after 2 weeks later and showed delayed CPN nerve conduction study (NCS) in 24 patients and deep peroneal nerve in 2 patients. Conclusion : We suggest that an awareness of these clinical characteristics and diagnostic assessment methods may help clinicians make a diagnosis of posture induced CPN palsy and preclude unnecessary studies or inappropriate treatment in foot drop patients.

Ankle Impingement Syndrome (족관절 충돌 증후군)

  • Choi, Gi-Won;Choi, Woo-Jin;Lee, Jin-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.1
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    • pp.19-25
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    • 2012
  • The ankle impingement syndrome is an established cause of ankle dysfunction. In most cases with suspected ankle impingement, the diagnosis can be possible on the basis of mechanism of injury involved and the clinical examination. An appropriate imaging study should be selected where clinical doubt about the exact diagnosis exists. Radiography plays an important role in the initial assessment of these conditions, especially in anterior and posterior impingement. Magnetic resonance arthrography seems to be the most accurate means of assessing the capsular abnormalities present in anterolateral and anteromedial impingement and for confirmation of possible concomitant injury. Surgical treatment can be considered for the patients who did not respond to conservative treatment for more than 6 months, and has a low complication rate and a high level of success.

Tuberculosis in Foot and Ankle (족부, 족관절 결핵)

  • Choi, Jang-Seok;Gwak,, Heui-Chul;Kim, Jung-Han;Chung, Hoon-Jae
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.203-209
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    • 2008
  • Purpose: To emphasize the importance of considering tuberculosis in atypical cases of foot and ankle by reporting clinical results of those cases. Materials and Methods: Seven cases which were diagnosed as tuberculosis around foot and ankle from March 1996 to June 2007 were included. We reviewed initial impressions, the time to be diagnosed, clinical symptoms, laboratory findings, radiological findings and the clinical results and complications. Results: We followed up at least 6 months ($6{\sim}24$ months) after surgery in all cases. Initially 2 cases had been diagnosed as cellulitis, 4 cases as chronic osteomyelitis, and 1 case as an ankle instability. Tuberculosis was diagnosed after biopsy in all cases. Mean duration of symptom was 15 months ($6{\sim}36$ months) except in infants. There were various radiologic manifestations such as osteopenia, bony erosion or destruction and cystic changes. Symptoms were relieved in all cases within 4 months with chemotherapy followed by surgical biopsy, except one ankle which had been misdiagnosed as ankle instability and joint destruction was developed after modified Brostrom surgery. Conclusion: It is important to perform a surgical biopsy for diagnosis and proper management even with a faint suspicion on tuberculosis in foot and ankle. And in case of need, when surgical biopsy is performed, curettage procedure may help to improve clinical result.

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Glomus Tumor in a Extradigital Lesion of Foot (A Case Report) (족지 외 족부에 발생한 사구종의 보고 (1예 보고))

  • Park, Hyun-Woo;Yoo, Moon-Jib;Hwang, Sung-Su
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.100-103
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    • 2007
  • Glomus tumors are uncommon soft tissue tumors which usually found in a subungual lesion of hand, producing pain. This uncommon tumors have been reported in other locations, including nasal cavity, stomach, mediastinum, heart, lung, and vagina etc. Especially, it was a very rare case found in an extradigital lesion of foot. Glomus tumors should not be ruled out for an extradigital mass lesion of foot and also any other locations. Although glomus tumors are generally considered a benign lesion, it should be considered that glomus tumors have also reported as a malignant type tumor, even the diagnosis based on histologic features not clinical one.

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