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A schwannoma is a slow-growing, neurogenic tumor composed of Schwann cells arising from a peripheral nerve sheath. The authors present a rare finding of a schwannoma of the sural nerve that was overlooked in a 51-year-old female with radiating foot pain. This case highlights the clinical implications and important teaching points in recognizing a schwannoma of the foot.
The foot of a newborn is a structure that is under formation and is susceptible to presenting pathologic disorders from the moment of birth. Evidence of the prevalence of clinodactyly in newborns is scarce. Therefore, the objective of this study was to determine that prevalence and its interrelationship with gestational and neonatal factors.
In a sample of 305 newborns (147 boys and 158 girls), the commonest podiatric medical alterations with either a genetic or a postural component present at the moment of birth were explored physically. The prevalence found in the sample was then related to different anthropometric, gestational, and racial/ethnic parameters of the newborn.
The sex of the newborn was unrelated to any podiatric medical pathology found. Clinodactyly was present in approximately 90% of the fifth toes studied. Breech or transverse fetal presentation and the width of the forefoot affected the appearance of clinodactyly of the fourth and fifth toes. The anthropometric differences between the feet of boys and girls were verified.
The presence of clinodactyly of the fourth and fifth toes in newborns is a frequent clinical finding and should, therefore, be considered in the podopediatric examination. In the neonatal population studied, the pathologic disorders explored did not depend on sex. The prevalence of fourth and fifth toe clinodactyly was significantly influenced by breech or transverse presentation and by forefoot width, but not by the mother's race/ethnicity.
The presence of clinodactyly of the fourth and fifth toes in newborns is a frequent clinical finding and should, therefore, be considered in the podopediatric examination. In the neonatal population studied, the pathologic disorders explored did not depend on sex. The prevalence of fourth and fifth toe clinodactyly was significantly influenced by breech or transverse presentation and by forefoot width, but not by the mother's race/ethnicity.
The medial longitudinal arch angle (LAA) of the foot has been used as an index of high and low arches. The LAA during the support phase of running (LAArun), which may be related to lower-limb injuries, is commonly predicted from the LAA at standing (LAAstand). However, it is not known whether this prediction is valid for all of the foot contact patterns. The purpose of this study was to verify whether prediction of the LAArun from the LAAstand is valid for different foot strike patterns.
The 26 participants were divided into a rearfoot strike group (n = 15) and a nonrearfoot strike group (n = 11). The LAA was obtained by measuring the angle formed between the line from the navicular bone to the medial malleolus and the line from the navicular bone to the first metatarsal head. The LAAstand and the minimum value of the LAArun, when the arch is most collapsed, were measured using a motion capture system.
There were no significant differences in the LAAstand, the LAArun, and the difference (LAAstand - LAArun) between the two groups. In both groups, a very strong and significant correlation was found between the LAAstand and the LAArun. Furthermore, a nearly identical equation for predicting the LAArun from the LAAstand was derived for the two groups.
The LAArun can be predicted from the LAAstand for any foot strike pattern with almost the same equation.
The LAArun can be predicted from the LAAstand for any foot strike pattern with almost the same equation.
Onychomycosis is the most common infectious nail disorder. Direct mycologic examination is still the cornerstone of diagnosis; however, it may take several weeks to obtain a result. Recently some dermoscopic patterns that can be useful in the diagnosis of onychomycosis were described. However, published data on dermoscopic features of onychomycosis are still limited.
We performed a prospective dermoscopic study of patients with positive fungal culture between April and December 2016. Patients with a final diagnosis of psoriasis or lichen planus were excluded from the study. Dermoscopy (polarized and nonpolarized) was performed.
Thirty-seven patients were enrolled, 24 women and 13 men (median ± SD age, 48.6 ± 16.1 years). Nail samples were culture positive for Trichophyton rubrum (89.2%), Trichophyton interdigitale (8.1%), and Candida albicans (2.7%). Distal and lateral subungual onychomycosis was the most frequent clinical subtype (59.5%). The most frequent dermoscopic features were subungual keratosis (73.0%), distal subungual longitudinal striae (70.3%), spikes of the proximal margin of an onycholytic area (59.5%), transverse superficial leukonychia (29.7%), and linear hemorrhage (13.5%). Brown chromonychia was most frequently seen with nonpolarized dermoscopy (66.6% versus 24%; P = .027).
Specific dermoscopic signs of onychomycosis are mostly related to the proximal invasion of the nail plate. Detection of these signs is simple and can, in some cases, help avoid mycologic testing.
Specific dermoscopic signs of onychomycosis are mostly related to the proximal invasion of the nail plate. Detection of these signs is simple and can, in some cases, help avoid mycologic testing.Midline metatarsal ray deficiencies, which occur in approximately half of congenital short limbs with fibular deficiency, provide the most distal and compelling manifestation of a fluid spectrum of human lower-extremity congenital long bone reductions; this spectrum syndromically affects the long bone triad of the proximal femur, fibula, and midline metatarsals. The bony deficiencies correspond to sites of rapid embryonic arterial transitioning. Long bones first begin to ossify because of vascular invasions of their respective mesenchymal/cartilage anlagen, proceeding in a proximal-to-distal sequence along the forming embryonic limb. A single-axis artery forms initially in the embryonic lower limb by means of vasculogenesis. Additional arteries evolve in overlapping transitional waves, in proximity to the various anlagen, during the sixth and seventh weeks after fertilization. An adult pattern of vessels presents by the eighth week. click here Arterial alterations, in the form of retained primitive embryonic vessels and/or reduced absent adult vessels, have been observed clinically at the aforementioned locations where skeletal reductions occur.
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