Examination of our feet can give podiatrists clues to other medical problems that can be occurring in other parts of our body. Certain systemic diseases or problems often present with the initial symptoms appearing in the feet first. The disease or problem may manifest itself in the feet but the problem is starting somewhere above the ankles.
One common problem podiatrists often see is a patient with a sore or ulcer on the foot. Ulcers are non healing sores that occur on any part of the foot and the initial thought may be that the ulcer is due to pressure or rubbing. However this is not always the case.
One recent example is a patient we saw that developed a new painful sore on their foot. After the doctor cared for the ulcer by cleaning it, padding it to relieve pain and pressure and prescribing antibiotics to insure the infection found in the ulcer would resolve the podiatrist began to examine the history and examine the total patient to investigate why the sore developed in the first place. Upon examination of the history it was discovered the patient had diabetes, which is a common cause for poor or reduced circulation in the feet and legs. Smoking and high cholesterol are also issues that can slow blood flow to the feet, however the patient was not a smoker and had normal cholesterol. When blood supply is reduced the skin can breakdown, can appear discolored, and become thin and form an ulcer due to the lack of oxygen and nutrients.
The examination of the circulation to both the feet revealed that the patient did not have any hair growth on the feet which is an indication of reduced circulation. The doctor also found that the pulse in the foot with the sore was much less than the foot that was unaffected. The next step was to determine what was the cause of the reduced blood flow to the foot.
The podiatrist then ordered a non invasive vascular arterial study and contacted a colleague who is a vascular surgeon.
Vascular doctors perform a test which can indicate how much blood flow is in the legs and feet. This test is a non painful test that involves putting blood pressure cuffs at several locations on the thigh, leg ankle and feet. This machine can then determine the percentage of normal blood flow into the leg and give an approximate location of any blockages.
In this patient it was found that the leg with the ulcer on the foot had a major blood vessel blockage in the thigh which reduced blood flow to the leg by more than 50 percent. This was significant enough to delay healing and cause ulcers to form. If the patient allowed the blockage to get worse then the leg could develop gangrene.
The next step is to have the patient undergo further tests to determine the specific location of the blockage and the type of blockage. After this is done the vascular doctor can determine the best procedure to remove the blockage and improve the blood flow to the leg.
It is important to realize the problem in the patient's thigh caused no symptoms in the thigh and the problem and pain first appeared in the foot. The patient went on to have the circulation restored in the leg and the sore on the foot healed nicely.
Other problems that often present in the feet include nerve pain that can radiate from pinched nerves in the back down into the foot or nerve pain can be from nerve damage from diabetes or Lupus or MS. Swelling found in the feet and ankles can be the result of a sprain or from a problem of high blood pressure or heart problems or kidney problems or bad varicose veins.
In many of these cases the problem first shows up in the foot but the solution to the problem is found above the ankles.
Dr. James Farrell is a licensed
podiatrist at the Westside Podiatry Center in Skaneateles. He can be reached at 685-3338
One recent example is a patient we saw that developed a new painful sore on their foot. After the doctor cared for the ulcer by cleaning it, padding it to relieve pain and pressure and prescribing antibiotics to insure the infection found in the ulcer would resolve the podiatrist began to examine the history and examine the total patient to investigate why the sore developed in the first place. Upon examination of the history it was discovered the patient had diabetes, which is a common cause for poor or reduced circulation in the feet and legs. Smoking and high cholesterol are also issues that can slow blood flow to the feet, however the patient was not a smoker and had normal cholesterol. When blood supply is reduced the skin can breakdown, can appear discolored, and become thin and form an ulcer due to the lack of oxygen and nutrients.
The examination of the circulation to both the feet revealed that the patient did not have any hair growth on the feet which is an indication of reduced circulation. The doctor also found that the pulse in the foot with the sore was much less than the foot that was unaffected. The next step was to determine what was the cause of the reduced blood flow to the foot.
The podiatrist then ordered a non invasive vascular arterial study and contacted a colleague who is a vascular surgeon.
Vascular doctors perform a test which can indicate how much blood flow is in the legs and feet. This test is a non painful test that involves putting blood pressure cuffs at several locations on the thigh, leg ankle and feet. This machine can then determine the percentage of normal blood flow into the leg and give an approximate location of any blockages.
In this patient it was found that the leg with the ulcer on the foot had a major blood vessel blockage in the thigh which reduced blood flow to the leg by more than 50 percent. This was significant enough to delay healing and cause ulcers to form. If the patient allowed the blockage to get worse then the leg could develop gangrene.
The next step is to have the patient undergo further tests to determine the specific location of the blockage and the type of blockage. After this is done the vascular doctor can determine the best procedure to remove the blockage and improve the blood flow to the leg.
It is important to realize the problem in the patient's thigh caused no symptoms in the thigh and the problem and pain first appeared in the foot. The patient went on to have the circulation restored in the leg and the sore on the foot healed nicely.
Other problems that often present in the feet include nerve pain that can radiate from pinched nerves in the back down into the foot or nerve pain can be from nerve damage from diabetes or Lupus or MS. Swelling found in the feet and ankles can be the result of a sprain or from a problem of high blood pressure or heart problems or kidney problems or bad varicose veins.
In many of these cases the problem first shows up in the foot but the solution to the problem is found above the ankles.
Dr. James Farrell is a licensed
podiatrist at the Westside Podiatry Center in Skaneateles. He can be reached at 685-3338
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