- Widespread Pressure Pain Hypersensitivity in Musculoskeletal and Nerve Trunk Areas as Sign of Altered Nociceptive Processing in Unilateral Plantar Heel Pain. [Journal Article]
- JPJ Pain 2018 Aug 16
- Our aim was to investigate the differences in pressure sensitivity over musculoskeletal and nerve symptomatic and distant areas between individuals with plantar heel pain and healthy subjects, and to...
Our aim was to investigate the differences in pressure sensitivity over musculoskeletal and nerve symptomatic and distant areas between individuals with plantar heel pain and healthy subjects, and to determine the relationship between sensitivity to pressure pain, foot pain, and fascia thickness. Thirty-five patients with unilateral chronic plantar heel pain and 35 matched healthy controls participated. Pressure pain thresholds (PPTs) were bilaterally assessed over several nerve trunks (median, radial, ulnar, common peroneal, tibial and sural nerve trunks) and musculoskeletal structures (calcaneus, medial gastrocnemius, tibialis anterior, second metacarpal) by an assessor blinded to the subject's condition. Pain was assessed with a numerical pain rate scale (NPRS, 0-10), impact of foot pain was assessed with the Foot Function Index (FFI), and plantar fascia thickness was measured via ultrasound imaging. The ANCOVA revealed lower widespread and bilateral PPTs over both nerve trunks and musculoskeletal structures in individuals with plantar heel pain (P<0.001). Female showed lower PPT than men in almost all points (P<0.001). PPT over peripheral nerve trunks of the lower extremity were significantly associated with the intensity of pain at first step on the morning and with foot function disability scale of the FFI (P<0.05). This study found widespread pressure pain hypersensitivity over both nerve trunks and musculoskeletal structures in individuals with unilateral chronic plantar heel pain, suggesting the presence of a central altered central nociceptive pain processing. Pressure hypersensitivity over nerve trunks on the lower extremity was associated with higher pain intensity and related-disability.
- Atraumatic Insufficiency Fractures of the Tarsal Bones - An Unusual Cause of Recurrent Heel Pain in a Patient with Rheumatoid Arthritis: A Case Report. [Journal Article]
- MOMalays Orthop J 2018; 12(2):59-61
- The incidence of insufficiency fractures is approximately 1% in rheumatoid arthritis patients. The predisposing factors are chronic inflammation, skeletal deformities, biomechanical stresses and oste...
The incidence of insufficiency fractures is approximately 1% in rheumatoid arthritis patients. The predisposing factors are chronic inflammation, skeletal deformities, biomechanical stresses and osteoporosis. The medications used in the treatment of rheumatoid arthritis such as Glucocorticosteroids and Methotrexate also contribute to the development of osteoporosis and insufficiency fractures. A 68-year old lady who was suffering from rheumatoid arthritis and on long term Methotrexate was seen in the outpatient clinic with recurrent episodes of heel pain. Examination revealed diffuse tenderness around the heel with full range of ankle movements but painful limitation of subtalar joint movements. Radiographic examination of the ankle showed a highly suspicious fracture of the calcaneus and confirmed on MRI as an insufficiency fracture. She was treated successfully with oral bisphosphonates and moon boot brace. She presented after two years with recurrent episodes of heel pain. The plain radiograph and MRI scan confirmed an insufficiency fracture of the talus. She was treated non-operatively with intravenous Zolendronic acid and bracing. In chronic rheumatoid arthritis patients especially on Methotrexate and Glucocorticoids a high index of suspicion of insufficiency fractures should be considered if they present with bone pain. MRI scan is the investigation of choice and is conclusive.
- The use of infrared thermography for detecting digital dermatitis in dairy cattle: What is the best measure of temperature and foot location to use? [Journal Article]
- VJVet J 2018; 237:26-33
- Lameness in dairy cattle is a persistent problem, indicating pain caused by underlying disease states and is associated with reduced milk yields. Digital dermatitis is a common cause of lameness. The...
Lameness in dairy cattle is a persistent problem, indicating pain caused by underlying disease states and is associated with reduced milk yields. Digital dermatitis is a common cause of lameness. Thermal imaging is a technique that may facilitate early detection of this disease and has the potential for use in automated detection systems. Previous studies with thermal imaging have imaged either the heels or the coronary band of the foot and typically only used the maximum temperature (Max) value as the outcome measure. This study investigated the utility of other statistical descriptors: 90th percentile (90PCT), 95th percentile (95PCT), standard deviation (SD) and coefficient of variation (CoV) and compared the utility of imaging the heel or coronary band. Images were collected from lame and healthy cows using a high-resolution thermal camera. Analyses were done at the cow and foot level. There were significant differences between lame and healthy feet detectable at the heels (95th percentile: P<0.05; SD: P<0.05) and coronary band (SD: P<0.05). Within lame cows, 95PCT values were higher at the heel (P<0.05) and Max values were higher at the coronary band (P<0.05) in the lame foot compared to the healthy foot. ROC analysis showed an AUC value of 0.72 for Max temperature and 0.68 for 95PCT at the heels. It was concluded that maximum temperature is the most accurate measure, but other statistical descriptors of temperature can be used to detect lameness. These may be useful in certain contexts, such as where there is contamination. Differentiation of lame from healthy feet was most apparent when imaging the heels.
- Sucrose vs. skin to skin care for preterm neonatal pain control-a randomized control trial. [Journal Article]
- JPJ Perinatol 2018 Aug 07
- CONCLUSIONS: SSC and Sucrose have comparable efficacy in managing pain in premature neonates.
- Evaluation of Long-term Outcomes Following Plantar Fasciotomy. [Journal Article]
- FAFoot Ankle Int 2018 Aug 01; :1071100718788546
- CONCLUSIONS: Long-term patient satisfaction was experienced by the majority of patients following plantar fasciotomy. Although 44% of patients continue to have postoperative complaints, 73% indicated that they were satisfied with their symptoms postoperatively, and 74% would undergo a similar procedure again.
- Incidence of calcaneal apophysitis in Northwest Istanbul. [Journal Article]
- BMBMC Musculoskelet Disord 2018 Jul 27; 19(1):267
- CONCLUSIONS: Although calcaneal apophysitis is a relatively common paediatric foot problem, due to its benign course and spontaneous healing capacity, most physicians are not interested in this topic. However, increased awareness of this diagnosis is important for reducing the rates of unnecessary radiological examinations and orthopaedic referrals. With increased knowledge, most cases may be diagnosed at the family physician level, which may decrease the economic burden on the health system. Incidence reports from various countries and regions may be published in the future.
- EVALUATING THE PROGRESS OF MID-PORTION ACHILLES TENDINOPATHY DURING REHABILITATION: A REVIEW OF OUTCOME MEASURES FOR MUSCLE STRUCTURE AND FUNCTION, TENDON STRUCTURE, AND NEURAL AND PAIN ASSOCIATED MECHANISMS. [Journal Article]
- IJInt J Sports Phys Ther 2018; 13(3):537-551
- CONCLUSIONS: Further research needs to be done to determine the role of muscle, tendon and neural adaptations using reliable outcome measures during the management of mid-portion AT.
- ALTERED SAGITTAL PLANE HIP BIOMECHANICS IN ADOLESCENT MALE DISTANCE RUNNERS WITH A HISTORY OF LOWER EXTREMITY INJURY. [Journal Article]
- IJInt J Sports Phys Ther 2018; 13(3):441-452
- CONCLUSIONS: The results of this study demonstrate increased peak stance phase hip flexion in a population of young adult male runners with a previous history of BSI. This association may represent an important preliminary finding in the development of a clinically relevant tool to identify risk of BSI. Due to the retrospective nature of this study, future prospective investigations are warranted to validate these findings to determine if these alterations are compensatory following an injury or predictive of a future injury.
- Schneider H, Baca J, Carpenter B, Dayton P, Fleischer A, Sachs B. American College of Foot and Ankle Surgeons Clinical Consensus Statement: Diagnosis and Treatment of Adult Acquired Infracalcaneal Heel Pain. J Foot Ankle Surg 2018. [Letter]
- JFJ Foot Ankle Surg 2018 Jul 20
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- Effect of applying reflexology massage on nitroglycerin-induced migraine-type headache: A placebo-controlled clinical trial. [Journal Article]
- AGRIAgri 2018; 30(3):116-122
- CONCLUSIONS: Reflexology massage can reduce the intensity of NTG-induced headache.