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A bit of everything

Patient 35 months of age. Come see your child walks badly and is afraid that it may fall. The pediatrician has said it is normal and will heal as she gets older.

share some of what was said by the pediatrician. Be monitored every few minutes in case tends to get worse.
Rx are pending to confirm a metatarsus adductus and classify, which at first seems mild. Usually improve with the development but will require attention if it tends to get worse. From time to exercise and slope of the Rx for other treatments.
In this case, a middle-aged patient, who complains derived and diagnosed as papilloma plant. " That's not a papilloma. It is a well-defined mass, not attached to the edges so that seems filiforme originating beyond the epidermis. Its consistency is hard and painful to pressure. Pressing the adjacent skin in planted-dorsal direction, the tumor goes further out. The treatment is surgical.

This is the strangest case I've found so far. I made a differential diagnosis with all kinds of conditions, even with the most rare. The first day I went, had a swelling, hyperthermia and pain in the MTP joint 2, 3 and 4 fingers of his right foot only (not the claw toes). 5 months of evolution, which started strong and continued pain without giving up any time, coming to hurt both the cargo and unloading.

The patient is 70 years old, and take treatment for a valve which have put him in the heart (other than asthma, dyslipidemia, hypertension, antiplatelet therapy, etc etc).

first thing done is symptomatic treatment: cryotherapy, NSAIDs and Kinesio Taping, Rx and analytical ask for, rheumatoid factor, creatinine, urea, ESR, CRP, and CBC.

Within a week the pain has dropped from a 7 to a 3 (visual scale of pain).

hyperthermia is not evident nor swelling in the MTPJ. The analytical

all values \u200b\u200bare normal, no signs of inflammation, infection, etc etc.

At the Rx, which is shown above (poor quality image, best seen in the original), one can see the great joint space existing in the 2 and 3 metatarsal heads with a flattening of the distal epiphysis of the 2 nd metatarsal.

first thing that came to mind is the Freiberg, but usually occurs in adolescents and usually has a look "dirtier" the Rx, with geodes, distortions, radiopaque areas.

some research, there are documented cases of Freiberg in adulthood and the etiology of this disease is still unclear, some people think that the consequence of osteonecrosis Aseptic is a consequence of a stroke due to vascular problems generally, or as another study suggests, the problem is due to anatomical variation in the collateral circulation of the 2 nd metatarsal is also widespread that the overhead through the mechanism of microtrauma may cause or trigger this condition and more if the patient has cardiovascular problems.

treatment is to distribute burdens and cushion the impact zones. Following symptomatic treatment, but watching every little while because of the amount of medications.

This is another case a priori it seemed that there was nothing and then turned out to be.

The patient came for consultation because it hurt in the caudal medial malleolus.

was recommended anti-inflammatory ointment and cryotherapy for tendinitis in her area and will cause irritation of the tibial nerve (also a lot of the problem is psychosomatic.) In 2 weeks I had no pain whatsoever in any area.

again in 2 weeks because it was the doctor (the patient is not from this area) pain in the bunion area and had nothing, though she was hurting. He had a blue-violet spots that hurt to touch. He wiped the area also uncovering an ulcer was infected (culture positive for staphylococci aureus. Allergic to penicillin). Given antibiotics and went to the doctor to come by the SS, the doctor to see the ulcer is offered to the wounds daily. It changes the erythromycin (sensitive antibiogram) by levofloxacin (rational use of antibacterials ¬ ¬)

Syndrome predislocación Plate flexor in a patient with a 1 ° radius dorsiflexed and have spent many hours standing.


The treatment will be to support the 1 st metatarsal head and climb the 2 nd to facilitate the descent of the proximal phalanx so as to alleviate the symptoms. Can go wrong as there are times that if we pass this increase is not supported selective.

Here is a pair of orthotics for SPPFP and the right is an insole, the same as the one below

sesamoiditis is for 5 years of evolution a result of moderate hallux limitus, in which no decrease of 1 MTT causes overload and hypertrophy of the sesamoids.

did not want a plantar orthosis being expensive and having to change the shoe, so it is chosen first measured by symptomatic treatment and these insoles.

presents a dorsal internal wedge supinate the calcaneus, and distal to raise a kinetic weedge retrocapital and proximal phalanx, with a Poron in the area of \u200b\u200bthe sesamoids to absorb impacts.

On the other hand, the planting area as seen in the photo above, a food to contain a little down the medial arch, and an elongated resin with a small swing in the area of \u200b\u200bthe sesamoids. The pain in 1 week has dropped 2 points (pain visual scale) and the impression is not much better and have to opt for a plantar orthoses, but to follow the evolution ......... Plantar orthoses not cure everything and failures and mistakes are the order of the day.