(first in a series of diagnostic modalities in podiatry)

Musculoskeletal ultrasonography is a very powerful diagnostic tool for the diagnosis of wide array of foot and ankle problems. At the Health Care Team of Dr. Peter F. Gregory, D.P.M. ultrasound may be ordered to help diagnose your foot problem. We use ultrasound typically for soft tissue problems, not bone conditions.  Some of the foot and ankle disorders that ultrasound may be used for are the following:

·        Foreign bodies

·        Morton's neuroma

·        Soft tissue masses

·        Bursitis or capsulitis of the joints

·        Ligament injuries

·        Tendonitis or tendon tears

·        Heel spurs or plantar fasciitis

·        Tarsal tunnel syndrome

·        Ultrasound guided injection or aspirations

What is Ultrasound? Most people know about ultrasound to image a baby or a gallbladder, but it has growing application in musculoskeletal disorders. Ultrasound is based on sound waves. Sound waves are emitted from a transducer probe that is applied to the body and these sound waves will pass into the body and then are reflected back to the transducer probe to be recorded. The recorded image is based on the density of the object that the sound waves encounter. An object with a high density appears white or brighter on the recorded image, while objects of low density will appear black or dark on the image. Intermediate densities will appear gray. The sound waves are recorded back to the machine, which will produce the image. This image will appear on our ultrasound screen and you the patient can immediately see the area that the technician is scanning and help to understand the problem you are having. This helps in directing the appropriate treatment for your condition.

Ultrasound is completely safe and painless. It also has no contraindications. There is no problem in having the examination if you are pregnant, have a pacemaker or other medical conditions that may prevent you from having a MRI or CT scan. Ultrasound also does not produce any radiation as with a CT scan or x-rays.

In preparing for the examination, you can eat and take your normal medications. The examination will take from 45 minutes to an hour based on the area being scanned. It is advised that you bath the day of the examination but avoid the use of any skin lotions or emollients. Also you should where loose fitting clothing or shorts to make it easier to perform the examination.

Patients come to our Livonia office for a wide range of foot and ankle issues, but one that seems to cause the most embarrassment is fungal toenails. This condition results in nails that are yellowed, thickened, crumbly, and unsightly. We want you to feel comfortable showing off your feet to the world, so let’s take a look at how to prevent fungal toenails from developing.

Not only is this condition embarrassing, it can also be a potential health threat to those who live with diabetes and other autoimmune disorders. These individuals have extra incentive for avoiding infection, but we know that no one wants to develop this problem.

Our practice provides effective treatment for this condition, but we are sure you’d rather avoid it in the first place. The good news is that there are steps you can take to prevent toenail fungus from developing. These include:

·         Practice good hygienic practices. Wash your feet daily, using soap and water, and then make sure you dry them thoroughly before putting on socks and shoes. Also, keeping your nails trimmed and properly maintained will reduce your infection risk.

·         Wear moisture-wicking socks. Fungi need moisture to survive, so keeping your feet dry is essential.

·         Choose footwear that breathes. In addition to socks that wick away moisture, shoes made from materials that allow the feet to breathe will lower your risk.

·         Use antifungal powders or spray. Treat your footwear with antifungal agents to eliminate spores that might be hiding inside.

·         Protect your feet in public places. Gym locker rooms and indoor pool decks are common sources of infection, so be sure to wear shower shoes or sandals if you are walking in such areas.

We hope that you are able to avoid an infection through the use of these tips, but keep in mind that we are always here to provide the treatment you need if an infection does occur.  The Foot Health Team at Dr. Peter F. Gregory, D.P.M. offers first-class skin and nail care for your feet and ankles, including effective toenail fungus treatment.

Don’t suffer from the embarrassment that comes with infected toenails! Simply give our Livonia office a call at 734-522-7676 for more information or to schedule an appointment today.

What Is A Hammertoe?  

Hammertoe is a contracture (bending) deformity of one or both joints of the second, third, fourth or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop.

Hammertoes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammertoes are flexible, and the symptoms can often be managed with noninvasive measures. But if left untreated, hammertoes can become more rigid and will not respond to nonsurgical treatment.

Because of the progressive nature of hammertoes, they should receive early attention. Hammertoes never get better without some kind of intervention.

Causes

The most common cause of hammertoe is a muscle/tendon imbalance. This imbalance, which leads to a bending of the toe, results from mechanical (structural) or neurological changes in the foot that occur over time in some people.

Hammertoes may be aggravated by shoes that do not fit properly. A hammertoe may result if a toe is too long and is forced into a cramped position when a tight shoe is worn. Occasionally, hammertoe is the result of an earlier trauma to the toe. In some people, hammertoes are inherited.

Symptoms

Common symptoms of hammertoes include:

·         Pain or irritation of the affected toe when wearing shoes.

·         Corns and calluses (a buildup of skin) on the toe, between two toes or on the ball of the foot. Corns are caused by constant friction against the shoe. They may be soft or hard, depending on their location.

·         Inflammation, redness or a burning sensation

·         Contracture of the toe

·         In more severe cases of hammertoe, open sores may form.
 

Diagnosis

Although hammertoes are readily apparent, to arrive at a diagnosis, the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the degree of the deformities and assess any changes that may have occurred.

Hammertoes are progressive—they do not go away by themselves and usually they will get worse over time. However, not all cases are alike—some hammertoes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.

Nonsurgical Treatment

There is a variety of treatment options for hammertoe. The treatment your foot and ankle surgeon selects will depend on the severity of your hammertoe and other factors.

A number of nonsurgical measures can be undertaken:

·         Padding corns and calluses. Your foot and ankle surgeon can provide or prescribe pads designed to shield corns from irritation. If you want to try over-the-counter pads, avoid the medicated types. Medicated pads are generally not recommended because they may contain a small amount of acid that can be harmful. Consult your surgeon about this option.

·         Changes in shoewear. Avoid shoes with pointed toes, shoes that are too short, or shoes with high heels—conditions that can force your toe against the front of the shoe. Instead, choose comfortable shoes with a deep, roomy toebox and heels no higher than two inches.

·         Orthotic devices. A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance. Injection therapy. Corticosteroid injections are sometimes used to ease pain and inflammation caused by hammertoe. 

·         Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation. Splinting/strapping. Splints or small straps may be applied by the surgeon to realign the bent toe.
 

When Is Surgery Needed?

In some cases, usually when the hammertoe has become more rigid and painful or when an open sore has developed, surgery is needed.

Often, patients with hammertoe have bunions or other foot deformities corrected at the same time. In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity, the number of toes involved, your age, your activity level and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.

 

For additional Information:  Please contact the Foot Health Team of Dr. Peter F. Gregory, D.P.M. at 734-522-7676 or visit our web site www.livoniapodiatrist.net

Skin is one of the important natural barriers that works along with our immune system to defend the body against organisms that can cause infection. The skin on our extremities - hands and feet - are the most vulnerable and require additional attention to remain healthy during the cold, dry months of winter.

 

The Foot Health Team of Dr. Peter F. Gregory, D.P.M.  recommend the following to minimize bacterial infection and cracking of the skin:

 

· Hydrate - Drink plenty of water each day. Consuming two liters of water daily is

  a good goal. Hydrated skin will remain flexible and allow our protective barrier

  to remain intact.

 

· Humidify - A humidifier adds moisture to the air to help prevent skin dryness.

 

· Hand hygiene - Hand-washing should occur: at the beginning and end of the

  workday; before eating or serving food; before applying make-up; after restroom

  activities; and at other times after contamination.

 

· Moisturize - Make sure to apply a moisturizer throughout the day to hands that

  are frequently washed.  Consider thick creams that are easily penetrate easily into the

  skin and specific foot creams to avoid painful cracking heels.

 

· Vitamins -Supplements can help keep your skin fueled with the nutrients it

   needs to be healthy. Antioxidants such as vitamin C and B Complex will boost

   collagen and help keep skin clear, while omega 3 fish oils can help decrease

   inflammation and make your skin look soft and supple.

 

Our podiatrists are experts in treating skin concerns of hands, feet and ankles.  Make time for a consultation today to create a personalized hand and foot skin care regime and to identify any potential problems.

 
Dr. Peter F. Gregory, D.P.M.

17316 Farmington Road

Livonia, MI  48152

734-522-7676

www.livoniapodiatrist.net

 

Your feet tell a story...We are here to listen! 

Most things in life either need or deeply benefit from some type of support. Cathedrals have buttresses. Rock climbers use belay lines. Even individual people benefit from supportive families and friends who are there in difficult times. Your feet aren't much different, particularly when they are struggling with uncomfortable problems like heel pain. Sometimes adding support for your heels is what you need to alleviate your discomfort.

Heel pain has many different causes, and for that reason, there are many different treatments designed to address the underlying problems. One of the big culprits is overuse and stress affecting the back of the foot. Repetitive hard impacts and poor biomechanics can wear down and aggravate your heels, contributing to your pain.

This is where having a little extra support can help. Your feet may need some additional cushioning to help them absorb shock and pressure without causing pain. Poor or faulty biomechanics may need to be adjusted or controlled to prevent overuse or extra strain on the back of the foot.

Custom orthotics can provide this for your feet, giving your painful heels the support they need. Heel pads or cushions provide that extra padding and shock absorption. That way you're better able to handle pressure on your heels. Arch supports and other orthotics can help stabilize your midfoot. This can help control abnormal foot motion that might be directing too much strain to your heels. In any case, the little extra support alleviates the strain and provides you with the relief you need.

The key, of course, is to have your heel pain diagnosed and see if supplemented support is really what you need. The Foot Health Team at Dr. Peter F. Gregory, D.P.M. will examine your lower limbs and see what factors are contributing to your condition. Then we'll be able to help you determine if orthotics are the missing piece for a little extra support. Don't suffer with heel pain when the answer to it could be so simple. Contact our office in Livonia today for more information or an appointment. You can reach us through the website or by calling (734) 522-7676.