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Overview of Foot and Ankle Disorders

By

Kendrick Alan Whitney

, DPM, Temple University School of Podiatric Medicine

Last full review/revision Dec 2019| Content last modified Dec 2019
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Bones of the foot

Bones of the foot
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In people with diabetes and people with peripheral vascular disease, careful examination of the feet, with evaluation of vascular sufficiency and neurologic integrity, should be done at least twice a year. People with these diseases should examine their own feet at least once a day.

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Considerations for Using Corticosteroid Injections

Corticosteroid injections should be used judiciously to avoid adverse effects. Injectable corticosteroids should be reserved for inflammation (such as gout Gout Gout is a disorder caused by hyperuricemia (serum urate > 6.8 mg/dL [> 0.4 mmol/L]) that results in the precipitation of monosodium urate crystals in and around joints, most often causing recurrent... read more Gout and disorders such as rheumatoid arthritis Rheumatoid Arthritis (RA) Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that primarily involves the joints. RA causes damage mediated by cytokines, chemokines, and metalloproteases. Characteristically... read more Rheumatoid Arthritis (RA) ), which is not present in most foot disorders. Because the tarsus, ankle, retrocalcaneal space, and dorsum of the toes have little connective tissue between the skin and underlying bone, injection of insoluble corticosteroids into these structures may cause depigmentation, atrophy, or ulceration, especially in elderly patients with peripheral arterial disease.

Insoluble corticosteroids can be given deeply rather than superficially with greater safety (eg, in the heel pad, tarsal canal, or metatarsal interspaces). The foot should be immobilized for a few days after tendon sheaths are injected. Unusual resistance to injection suggests injection into a tendon. Repeated injection into a tendon should be avoided because the tendon may weaken (partially tear), predisposing to subsequent rupture.

Drugs Mentioned In This Article

Drug Name Select Trade
MINOCIN
COUMADIN
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