Podiatry Today Current Issue

News and Trends

admin — Wed, 03 Sep 2008 17:01:41 -0400

CMS To Begin Competitive Bidding Process For DME

Changes are underway at the federal level to the durable medical equipment (DME) system for Medicare patients and may have an effect on podiatry practices and patient care. The Center for Medicare and Medicaid Services (CMS) proposes a system that will open up the durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) system to competitive bidding. As part of the plan, only those suppliers chosen through the bidding will be permitted to supply items to Medicare beneficiaries in product areas cover

Rethinking Proper Patient Selection For Limb Salvage Interventions

admin — Wed, 03 Sep 2008 17:01:41 -0400

Reducing the number of lower extremity amputations is a goal for all clinicians caring for patients with diabetes. In spite of this, the numbers of limb-threatening infections and subsequent amputations continue to rise each year. While medical and surgical interventions are frequently successful in facilitating limb salvage in patients facing amputation, failures in limb salvage attempts do occur. These failures result in multiple trips to the operating room, significant potential morbidity and prolonged disability.

In order to more accurately predict

Emerging Innovations In Treatment

admin — Wed, 03 Sep 2008 17:01:41 -0400

As the podiatry profession continues to grow, new technologies emerge to help DPMs address key challenges in providing optimal care for their patients. These modalities include not only novel antibiotics to fight infection but a time-tested therapy that is just gaining prominence in the United States. Podiatrists may also enjoy the benefits of new cryogenic technology, wound care innovations and a re-emerging surgical procedure. Without further delay, let us take a closer look at these emerging innovations.

1. Bacteriophage Therapy (Phage Internation

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When A Patient Presents With A Lower Extremity Rash

admin — Wed, 03 Sep 2008 17:01:41 -0400

   Podiatric physicians are often presented with dilemmas when diagnosing various dermatological conditions as these conditions may have overlapping symptoms. An accurate diagnosis is dependent on the patient history, physical examination and asking key questions to elicit telling answers from the patient. Accordingly, we have launched a new bimonthly column, “Dermatology Diagnosis,” that will test one’s skills in diagnosing dermatological conditions. Without further delay, let us consider the first case.

   A 26-year-old male presents with a four-day h

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How To Detect And Treat Pruritus

admin — Wed, 03 Sep 2008 17:01:41 -0400

   Pruritus is a symptom complex rather than a dermatological condition. It is a very common manifestation of skin diseases described as an itch that makes a person want to scratch. It can be frustrating and cause some patients severe discomfort. Chronic itching can lead to sleeplessness, anxiety, depression and behavioral disorders (especially in young children). Symptoms of pruritus can be a result of skin conditions such as dry skin (xerosis), atopic dermatitis, eczema and contact dermatitis. Pruritus can also present with certain internal disorders or may be due to altered p

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Key Insights For Addressing Infected Hardware

admin — Wed, 03 Sep 2008 17:01:41 -0400

   Screws, plates, staples, pins and wires are the hardware that the foot and ankle surgeon uses to fixate fractures, fusions and/or osteotomies. An infection involving hardware may jeopardize the bone healing process and is a precarious situation for both the patient and the surgeon. In some situations, the infection may be easily managed yet it can be limb threatening in other situations. Like any infection, early diagnosis is paramount.

   Hardware is necessary to stabilize osseous segments until one achieves complete bone healing, a process that typically

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Point-Counterpoint: Intermetatarsal Neuromas: Is Neurectomy The Best Option?

admin — Wed, 03 Sep 2008 17:01:41 -0400

   Yes. By Patrick A. DeHeer, DPM. While this author has had success with conservative treatment, particularly sclerosing therapy, he emphasizes that a plantar approach to the neurectomy can be effective when surgery is indicated.

   Morton’s neuroma is a commonly encountered forefoot pathology that has many different treatment options available for the foot and ankle specialist. What are these options, when does one implement each type of treatment and when does surgical intervention become the best option for the patient?

   Before lookin

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Case Studies In Painful Diabetic Neuropathy

admin — Wed, 03 Sep 2008 17:01:41 -0400

   Approximately 800,000 new cases of diabetes mellitus are diagnosed each year. The disease affects over 18 million people, approximately 6 percent of the population of the United States.¹ Type 2 diabetes, which is typically not diagnosed in patients under age 45, is overwhelmingly the most prevalent of all types of diabetes as it affects nearly 17 million Americans.¹ Symptoms of Type 2 diabetes are often not detected until they are severe or until patients seek treatment for related complications.² Diabetes complications can result in blindness

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A Closer Look At Advances In Functional Lab Testing

admin — Wed, 03 Sep 2008 17:01:41 -0400

   The modern podiatric physician is faced with many challenges when it comes to appropriate patient selection for surgical procedures. Specifically, when it comes to the high-risk patient with diabetes, there are potential challenges that can lead to postoperative complications and potential lawsuits. Indeed, some of these high-risk patients may experience delayed wound healing with no obvious preoperative disease elucidated in the preoperative history, physical and conventional laboratory studies.

   Faced with these challenges, the astute podiatric physician

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A Closer Look At Redefining Charcot

admin — Wed, 03 Sep 2008 17:01:41 -0400

   For foot and ankle specialists, the diagnosis and complete management of neuropathic arthropathy ranks among the most daunting challenges. Currently, one makes the clinical diagnosis when there is a compilation of clinical and radiographic findings suspicious for the condition. The diagnosis relies upon the histopathology to identify the neuropathic joint destruction.

   Once one makes a diagnosis, either definitively or clinically, the treatment approach remains the discretion of the physician. Those best trained for treating this condition rely on the lit

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