RESPONSES / COMMENTS
02/10/2007
RE: Charles Bradley, DPM - DSC Award
I had the splendid opportunity of working with Dr. Bradley at CCPM while I was a student and resident. Whenever I was assigned to scrub in one of his cases, I was always excited. He always made me feel at ease. Thank you and congraulations, Dr. Bradley.
Mitchell Moser, DPM, Roseville, CA
RE: Exertional Compartment Syndrome (Cory Pilling, DPM)
From: Multiple Respondents
It might be helpful to re-assess your diagnosis. Often times it is helpful to have the patient perform rigorous exercise in the office, such as running, repetitive stair climbing just to reproduce the symptoms. An examination with the patient symptomatic would confirm your diagnosis.
FYI, the soleus is in the superficial posterior compartment. Using a Stryker compartment pressure-measuring device, you could measure the compartment pressures pre and post exercise. If a significant rise in pre and post exercise pressures is documented, this would confirm your diagnosis. Your local hospital ER will likely have the Stryker probe needed. I am not aware of any conservative treatment options. Fasciotomy is usually necessary and effective.
John Levin, DPM, Atlantis FL, John.Levin@OCPBC.com
My primary question to this patient would be how serious a competitor is she. If she is expecting to be drafted by a college or get a scholarship, this situation must be treated more seriously. If she is a serious athlete than she should be referred back to her orthopedist or a physiatrist for compartment pressure testing for exercise-induced compartment syndrome, while inducing symptoms on a treadmill. If her compartment pressures are not elevated than further investigation with MRI would be prudent.
If her pressures are elevated consideration for ice therapy prior to initiating her workouts, as well as, during and afterwards. In lieu of utilizing orthotics in her shoes while in competition, will she be allowed to use a Campbell's rest strap with a longitudinal arch to control her pronation?
Unfortunately, oftentimes these problems require surgical intervention to get some relief. But most importantly, make sure the diagnosis is correct.
Simon Young, DPM, NY, NY Simon Young@juno.com
For this patient, exertional compartment syndrome is plausible, but uncommon. I suggest obtaining an MRI to r/o an accessory soleus muscle.
Jeffrey Siegel, DPM, Philadelphia, PA, heeldoc1@aol.com
RE: Podiatry Internet Journal
From: Al Kline, DPM
The Podiatry Internet Journal or PIJ is an open-access, on-line resource journal introduced in January 2007 to enable rapid access information of case study articles relevant to the field of Podiatry. I began this project with the help of my fellow colleagues in an effort to establish an internet journal that will allow rapid access to information when submitted. The journal online can be accessed at www.podiatry.wordpress.com
The Podiatry Internet Journal began accepting articles in January 2007. The journal will accept articles and publish them online, usually within 1 to 2 weeks of submission. The concept of open-access availability of information is a unique switch from online, subscription-based articles. The journal also will publish a PDF version of submitted articles in a journal-like format very similar to what you see in your favorite podiatry journal. The PIJ is directing its article content to case study presentations and information relevant to podiatry as we practice. A major advantage is its speed of delivery in information.
Just last week, the journal received an article from an orthopedic doctor recently published in the JFAS. His article was edited and uploaded within one week of submission. It is this kind of fast access to information that will likely enhance our need for rapid information and knowledge in our field. We are actively seeking support of active podiatrists, residency directors, and residents to add and share case information through our unique site.
Al Kline, DPM, Corpus Christi, TX, al@kline.net
Editor’s comment: Through an agreement with PIJ, selected articles from PIJ will be reprinted in Podiatry Management.
RE: Radiographs for Nail Pathology (Allen Jacobs, DPM)
From: Multiple Respondents
Editor’s note: This discussion continues at: http://www.podiatrym.com/letters2.cfm?id=12692&start=1
