DOCSLIB.ORG

Podiatry Specialty ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Podiatry and Top 20 Codes

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

Podiatry Specialty ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Podiatry and Top 20 codes Chapter 1 Certain Infectious and Parasitic Diseases Terminology changes: The term “sepsis” (ICD-10-CM) has replaced the term “septicemia” (ICD-9-CM). “Urosepsis” is a nonspecific term and is not coded in ICD-10-CM. Should a provider use this term, he or she must be queried for clarification. Infections resistant to antibiotics require the use of an additional code for any associated drug resistance only if the infection code does not identify drug resistance (Z16 category, resistance to antimicrobial drugs if the infection code does not identify drug resistance). Expansion of the codes to reflect manifestations of the disease. Chapter 12 Diseases of the Skin and Subcutaneous Tissue Code expansions: Updates to medical terminology. Anemia is the most common condition included in this chapter. The use of specific terminology is important in applying codes for this condition. Procedural complications affecting the spleen are included in Chapter 3 of ICD-10-CM. Chapter 13 Diseases of the Musculoskeletal System and Connective Tissue Most of the codes within this chapter have site and laterality designations. ICD-10-CM identifies three different causes for pathological fractures: “neoplastic disease,” “osteoporosis” and other specified disease. ICD-10-CM introduces the seventh character that describes type of encounter, or the state of a fracture’s healing and any sequela. Some codes in this chapter will have the seventh character applied. (Source: 2014 Draft ICD-10-CM Official Guidelines for Coding and Reporting) Examples of Coding Laterality M79.671 – Pain in right foot M79.672 – Pain in left foot The top 20 Podiatry Specialty ICD-9 to ICD-10 mappings is found in the chart below. Top 1-20 ICD-9 Description ICD-9 ICD-10 Description ICD-10 1 110.1 Dermatophytosis of nail B35.1 Tinea unguium 2 703.0 Ingrowing nail L60.0 Ingrowing nail 3 728.71 Plantar fascial fibromatosis M72.2 Plantar fascial fibromatosis 4 729.5 Pain in limb M79.601 Pain in right arm M79.602 Pain in left arm 1 Top 1-20 ICD-9 Description ICD-9 ICD-10 Description ICD-10 M79.603 Pain in arm, unspecified M79.604 Pain in right leg M79.605 Pain in left leg M79.606 Pain in leg, unspecified M79.609 Pain in unspecified limb M79.621 Pain in right upper arm M79.622 Pain in left upper arm M79.629 Pain in unspecified upper arm M79.631 Pain in right forearm M79.632 Pain in left forearm M79.639 Pain in unspecified forearm M79.641 Pain in right hand M79.642 Pain in left hand M79.643 Pain in unspecified hand M79.644 Pain in right finger(s) M79.645 Pain in left finger (s) M79.646 Pain in unspecified finger(s) M79.651 Pain in right thigh M79.652 Pain in left thigh M79.659 Pain in unspecified thigh M79.661 Pain in right lower leg M79.662 Pain in left lower leg M79.669 Pain in unspecified lower leg M79.671 Pain in right foot M79.672 Pain in left foot M79.673 Pain in unspecified foot M79.674 Pain in right toe(s) M79.675 Pain in left toe(s) M79.676 Pain in unspecified toe(s) Atherosclerosis of native arteries of right 5 707.15 Ulcer of other part of foot I70.235 leg w/ulceration of other part of foot Atherosclerosis of native arteries of left I70.245 leg w/ulceration of other part of foot 2 Top 1-20 ICD-9 Description ICD-9 ICD-10 Description ICD-10 Atherosclerosis of unspecified type of bypass graft(s) of the right leg I70.335 w/ulceration of other part of foot Atherosclerosis of unspecified type of bypass graft(s) of the left leg w/ulceration I70.345 of other part of foot Atherosclerosis of autologous vein bypass graft(s) of the right leg I70.435 w/ulceration of other part of foot Atherosclerosis of autologous vein bypass graft(s) of the left leg w/ulceration I70.445 of other part of foot Atherosclerosis of nonautologous biological bypass graft(s) of the right leg I70.535 w/ulceration of other part of foot Atherosclerosis of nonautologous biological bypass graft(s) of the left leg I70.545 w/ulceration of other part of foot Atherosclerosis of nonbiological bypass graft(s) of the right leg w/ulceration of I70.635 other part of foot Atherosclerosis of nonbiological bypass graft(s) of the left leg w/ulceration of other I70.645 part of foot Atherosclerosis of other type of bypass graft(s) of the right leg w/ulceration of I70.735 other part of foot Atherosclerosis of other type of bypass graft(s) of the left leg w/ulceration of other I70.745 part of foot Non-pressure chronic ulcer of other part of unspecified foot limited to breakdown L97.501 of skin Non-pressure chronic ulcer of other part L97.502 of unspecified foot w/fat layer exposed Non-pressure chronic ulcer of other part L97.503 of unspecified foot w/necrosis of muscle Non-pressure chronic ulcer of other part L97.504 of unspecified foot w/necrosis of bone Non-pressure chronic ulcer of other part L97.509 of unspecified foot w/unspecified severity Non-pressure chronic ulcer of other part L97.511 of right foot limited to breakdown of skin Non-pressure chronic ulcer of other part L97.512 of right foot w/fat layer exposed Non-pressure chronic ulcer of other part L97.513 of right foot w/necrosis of muscle Non-pressure chronic ulcer of other part L97.514 of right foot w/necrosis of bone 3 Top 1-20 ICD-9 Description ICD-9 ICD-10 Description ICD-10 Non-pressure chronic ulcer of other part L97.519 of right foot w/unspecified severity Non-pressure chronic ulcer of other part L97.521 of left foot limited to breakdown of skin Non-pressure chronic ulcer of other part L97.522 of left foot w/fat layer exposed Non-pressure chronic ulcer of other part L97.523 of left foot w/necrosis of muscle Non-pressure chronic ulcer of other part L97.524 of left foot w/necrosis of bone Non-pressure chronic ulcer of other part L97.529 of left foot w/unspecified severity 6 726.90 Enthesopathy of unspecified site M77.9 Enthesopathy unspecified 7 726.79 Other enthesopathy of ankle & tarsus M76.70 Peroneal tendinitis, unspecified leg M76.71 Peroneal tendinitis, right leg M76.72 Peroneal tendinitis, left leg M77.50 Other enthesopathy of unspecified foot M77.51 Other enthesopathy of right foot M77.52 Other enthesopathy of left foot 8 735.0 Hallux valgus (acquired) M20.10 Hallux valgus (acquired) unspecified foot M20.11 Hallux valgus (acquired) right foot M20.12 Hallux valgus (acquired) left foot 9 719.47 Pain in joint of ankle & foot M25.571 Pain in right ankle and joints of right foot M25.572 Pain in leftt ankle and joints of left foot Pain in unspecified ankle and joints of M25.579 unspecified foot Other hammer toes (acquired) 10 735.4 Other hammer toe (acquired) M20.40 unspecified foot M20.41 Other hammer toes (acquired) right foot M20.42 Other hammer toes (acquired) left foot Diabetes mellitus without mention of complication, type II or unspecified type, Type 2 diabetes mellitus without 11 25000 not stated as uncontrolled E11.9 complications Other specified diabetes mellitus without E13.9 complications 12 078.12 Plantar wart B07.0 Plantar wart 13 078.19 Other specified viral warts B07.8 Other specified viral warts Lesion of plantar nerve, unspecified lower 14 355.6 Lesion of plantar nerve G57.60 limb G57.61 Lesion of plantar nerve, right lower limb G57.62 Lesion of plantar nerve, left lower limb Diabetes with neurological manifestations, type II or unspecified Type 2 diabetes mellitus with diabetic 15 250.60 type, not stated as uncontrolled E11.40 neuropathy, unspecified Type 2 diabetes mellitus with diabetic E11.41 mononeuropathy Type 2 diabetes mellitus with diabetic E11.42 polyneuropathy Type 2 diabetes mellitus with diabetic E11.43 autonomic (poly)neuropathy Type 2 diabetes mellitus with other E11.49 diabetic neurological complication 4 Top 1-20 ICD-9 Description ICD-9 ICD-10 Description ICD-10 Type 2 diabetes mellitus with diabetic E11.610 neuropathic arthropathy Other specified diabetes mellitus with E13.40 diabetic neuropathy, unspecified Other specified diabetes mellitus with E13.41 diabetic mononeuropathy Other specified diabetes mellitus with E13.42 diabetic polyneuropathy Other specified diabetes mellitus with E13.43 diabetic autonomic (poly)neuropathy Other specified diabetes mellitus with E13.44 diabetic amyotrophy Other specified diabetes mellitus with E13.49 other diabetic neurological complication Other specified diabetes mellitus with E13.610 diabetic neuropathic arthropathy 16 726.73 Calcaneal spur M77.30 Calcaneal spur, unspecified foot M77.31 Calcaneal spur, right foot M77.32 Calcaneal spur, left foot 17 443.9 Peripheral vascular disease, unspecified I73.9 Peripheral vascular disease, unspecified 18 681.11 Onychia and paronychia of toe L03.031 Cellulitis of right toe L03.032 Cellulitis of left toe L03.039 Cellulitis of unspecified toe Atherosclerosis of native arteries of right 19 707.14 Ulcer of heel and midfoot I70.234 leg with ulceration of heel and midfoot Atherosclerosis of native arteries of left I70.244 leg with ulceration of heel and midfoot Atherosclerosis of unspecified type of bypass graft(s) of the right leg with I70.334 ulceration of heel and midfoot Atherosclerosis of unspecified type of bypass graft(s) of the left leg with I70.344 ulceration of heel and midfoot Atherosclerosis of autologous vein bypass graft(s) of the right leg with I70.434 ulceration of heel and midfoot Atherosclerosis of autologous vein bypass graft(s) of the left leg with I70.444 ulceration of heel and midfoot Atherosclerosis of nonautologous biological bypass graft(s) of the right leg I70.534 with ulceration of heel and midfoot Atherosclerosis
Recommended publications

  • Evaluation of the Inferior Calcaneal Spurs Influence on Plantar Fascia

    Evaluation of the Inferior Calcaneal Spurs Influence on Plantar Fascia Thickness Clint Jiroux, PMS-II ; Kyle Schwickerath, PMS-II; Frank Felix, PMS-II; Chad Smith, PMS-II; Matt Greenblatt, PMS-II Arizona School of Podiatric Medicine – Midwestern University Printing: This poster is 48” wide by 36” high. It’s STATEMENT OF PURPOSE ANALYSIS & DISCUSSION designed to be printed on a large • Plantar fasciitis is a common pathology associated with plantar heel pain. It is Through ultrasound, our research revealed the spur does not show a reported that in the United States, two million patients are treated for plantar relationship to the thickness of the plantar fascia. Thus, based on our data, printer. fasciitis annually, and accounts for 15% of all foot disorders (1). A frequent diagnostic measurements of the fascia band thickness should not take into association with plantar fasciitis is the presence of an inferior calcaneal heel consideration the presence of a heel spur. This data is supportive to the spur. Often debated by medical professionals; Is the heel spur an incidental or consensus of 4mm being the diagnostic value for plantar fasciitis. Additionally, causation of plantar fasciitis (2-4)? Using ultrasound imaging, the plantar fascia this strengthens support of the heel spur being an incidental finding with plantar Figure 1. Type A inferior calcaneal spur that extends above the plantar fascia. (A) Type B inferior calcaneal Figure 2. Longitudinal ultrasound of the plantar fascia with the presence of an inferior calcaneal spur. (A) A fasciitis. thickness can be quantifiably measured to determine plantar fasciitis. An spur that extends into the plantar fascia.
  • Bioarchaeological Implications of Calcaneal Spurs in the Medieval Nubian Population of Kulubnarti

    Bioarchaeological Implications of Calcaneal Spurs in the Medieval Nubian Population of Kulubnarti

    Bioarchaeological Implications of Calcaneal Spurs in the Medieval Nubian Population of Kulubnarti Lindsay Marker Department of Anthropology Primary Thesis Advisor Matthew Sponheimer, Department of Anthropology Defense Committee Members Douglas Bamforth, Department of Anthropology Patricia Sullivan, Department of English University of Colorado at Boulder April 2016 1 Table of Contents List of Figures ............................................................................................................................. 4 Abstract …................................................................................................................................... 6 Chapter 1: Introduction …........................................................................................................... 8 Chapter 2: Anatomy …................................................................................................................ 11 2.1 Chapter Overview …................................................................................................. 11 2.2 Bone Composition …................................................................................................ 11 2.3 Plantar Foot Anatomy …........................................................................................... 12 2.4 Posterior Foot Anatomy …........................................................................................ 15 Chapter 3: Literature Review and Background of Calcaneal Enthesophytes ............................. 18 3.1 Chapter Overview …................................................................................................
  • The Painful Heel Comparative Study in Rheumatoid Arthritis, Ankylosing Spondylitis, Reiter's Syndrome, and Generalized Osteoarthrosis

    The Painful Heel Comparative Study in Rheumatoid Arthritis, Ankylosing Spondylitis, Reiter's Syndrome, and Generalized Osteoarthrosis

    Ann Rheum Dis: first published as 10.1136/ard.36.4.343 on 1 August 1977. Downloaded from Annals of the Rheumatic Diseases, 1977, 36, 343-348 The painful heel Comparative study in rheumatoid arthritis, ankylosing spondylitis, Reiter's syndrome, and generalized osteoarthrosis J. C. GERSTER, T. L. VISCHER, A. BENNANI, AND G. H. FALLET From the Department of Medicine, Division of Rheumatology, University Hospital, Geneva, Switzerland SUMMARY This study presents the frequency of severe and mild talalgias in unselected, consecutive patients with rheumatoid arthritis, ankylosing spondylitis, Reiter's syndrome, and generalized osteoarthosis. Achilles tendinitis and plantar fasciitis caused a severe talalgia and they were observed mainly in males with Reiter's syndrome or ankylosing spondylitis. On the other hand, sub-Achilles bursitis more frequently affected women with rheumatoid arthritis and rarely gave rise to severe talalgias. The simple calcaneal spur was associated with generalized osteoarthrosis and its frequency increased with age. This condition was not related to talalgias. Finally, clinical and radiological involvement of the subtalar and midtarsal joints were observed mainly in rheumatoid arthritis and occasionally caused apes valgoplanus. copyright. A 'painful heel' syndrome occurs at times in patients psoriasis, urethritis, conjunctivitis, or enterocolitis. with inflammatory rheumatic disease or osteo- The antigen HLA B27 was present in 29 patients arthrosis, causing significant clinical problems. Very (80%O). few studies have investigated the frequency and characteristics of this syndrome. Therefore we have RS 16 PATIENTS studied unselected groups of patients with rheuma- All of our patients had the complete triad (non- toid arthritis (RA), ankylosing spondylitis (AS), gonococcal urethritis, arthritis, and conjunctivitis).
  • Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma (A57079)

    Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma (A57079)

    Local Coverage Article: Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma (A57079) Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Contractor Information CONTRACTOR NAME CONTRACT TYPE CONTRACT JURISDICTION STATE(S) NUMBER Noridian Healthcare Solutions, A and B MAC 01111 - MAC A J - E California - Entire State LLC Noridian Healthcare Solutions, A and B MAC 01112 - MAC B J - E California - Northern LLC Noridian Healthcare Solutions, A and B MAC 01182 - MAC B J - E California - Southern LLC Noridian Healthcare Solutions, A and B MAC 01211 - MAC A J - E American Samoa LLC Guam Hawaii Northern Mariana Islands Noridian Healthcare Solutions, A and B MAC 01212 - MAC B J - E American Samoa LLC Guam Hawaii Northern Mariana Islands Noridian Healthcare Solutions, A and B MAC 01311 - MAC A J - E Nevada LLC Noridian Healthcare Solutions, A and B MAC 01312 - MAC B J - E Nevada LLC Noridian Healthcare Solutions, A and B MAC 01911 - MAC A J - E American Samoa LLC California - Entire State Guam Hawaii Nevada Northern Mariana Created on 09/28/2019. Page 1 of 33 CONTRACTOR NAME CONTRACT TYPE CONTRACT JURISDICTION STATE(S) NUMBER Islands Article Information General Information Original Effective Date 10/01/2019 Article ID Revision Effective Date A57079 N/A Article Title Revision Ending Date Billing and Coding: Injections - Tendon, Ligament, N/A Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma Retirement Date N/A Article Type Billing and Coding AMA CPT / ADA CDT / AHA NUBC Copyright Statement CPT codes, descriptions and other data only are copyright 2018 American Medical Association.
  • Haglund's Syndrome, Retrocalaneal Exostosis

    Haglund's Syndrome, Retrocalaneal Exostosis

    Open Access Review Article DOI: 10.7759/cureus.820 Haglund’s Syndrome: A Commonly Seen Mysterious Condition Raju Vaishya 1 , Amit Kumar Agarwal 1 , Ahmad Tariq Azizi 2 , Vipul Vijay 1 1. Orthopaedics, Indraprastha Apollo Hospitals 2. Orthopaedics, Herat Regional Hospital, Herat, Afghanistan Corresponding author: Amit Kumar Agarwal, [email protected] Abstract Haglund’s deformity was first described by Patrick Haglund in 1927. It is also known as retrocalcaneal exostosis, Mulholland deformity, and ‘pump bump.' It is a very common clinical condition, but still poorly understood. Haglund’s deformity is an abnormality of the bone and soft tissues in the foot. An enlargement of the bony section of the heel (where the Achilles tendon is inserted) triggers this condition. The soft tissue near the back of the heel can become irritated when the large, bony lump rubs against rigid shoes. The aetiology is not well known, but some probable causes like a tight Achilles tendon, a high arch of the foot, and heredity have been suggested as causes. Middle age is the most common age of affection, females are more affected than males, and the occurence is often bilateral. A clinical feature of this condition is pain in the back of the heel, which is more after rest. Clinical evaluation and lateral radiographs of the ankle are mostly enough to make a diagnosis of Haglund’s syndrome. Haglund’s syndrome is often treated conservatively by altering the heel height in shoe wear, orthosis, physiotherapy, and anti-inflammatory drugs. Surgical excision of the bony exostoses of the calcaneum is only required in resistant cases.
  • Musculoskeletal Diagnostic Imaging

    Musculoskeletal Diagnostic Imaging

    Musculoskeletal Diagnostic Imaging Vivek Kalia, MD MPH October 02, 2019 Course: Sports Medicine for the Primary Care Physician Department of Radiology University of Michigan @VivekKaliaMD [email protected] Objectives • To review anatomy of joints which commonly present for evaluation in the primary care setting • To review basic clinical features of particular musculoskeletal conditions affecting these joints • To review key imaging features of particular musculoskeletal conditions affecting these joints Outline • Joints – Shoulder – Hip • Rotator Cuff Tendinosis / • Osteoarthritis Tendinitis • (Greater) Trochanteric bursitis • Rotator Cuff Tears • Hip Abductor (Gluteal Tendon) • Adhesive Capsulitis (Frozen Tears Shoulder) • Hamstrings Tendinosis / Tears – Elbow – Knee • Lateral Epicondylitis • Osteoarthritis • Medical Epicondylitis • Popliteal / Baker’s cyst – Hand/Wrist • Meniscus Tear • Rheumatoid Arthritis • Ligament Tear • Osteoarthritis • Cartilage Wear Outline • Joints – Ankle/Foot • Osteoarthritis • Plantar Fasciitis • Spine – Degenerative Disc Disease – Wedge Compression Deformity / Fracture Shoulder Shoulder Rotator Cuff Tendinosis / Tendinitis • Rotator cuff comprised of 4 muscles/tendons: – Supraspinatus – Infraspinatus – Teres minor – Subscapularis • Theory of rotator cuff degeneration / tearing with time: – Degenerative partial-thickness tears allow superior migration of the humeral head in turn causes abrasion of the rotator cuff tendons against the undersurface of the acromion full-thickness tears may progress to
  • 12-1098 ) Issued: September 19, 2012 U.S

    12-1098 ) Issued: September 19, 2012 U.S

    United States Department of Labor Employees’ Compensation Appeals Board __________________________________________ ) S.R., Appellant ) ) and ) Docket No. 12-1098 ) Issued: September 19, 2012 U.S. POSTAL SERVICE, POST OFFICE, ) Harrisburg, PA, Employer ) __________________________________________ ) Appearances: Case Submitted on the Record Appellant, pro se Office of Solicitor, for the Director DECISION AND ORDER Before: RICHARD J. DASCHBACH, Chief Judge ALEC J. KOROMILAS, Alternate Judge MICHAEL E. GROOM, Alternate Judge JURISDICTION On April 23, 2012 appellant filed a timely appeal from a December 15, 2011 merit decision of the Office of Workers’ Compensation Programs (OWCP) and an April 6, 2012 nonmerit decision denying his request for reconsideration. Pursuant to the Federal Employees’ Compensation Act1 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction over the merits of this case. ISSUES The issues are: (1) whether appellant met his burden of proof to establish that he sustained a right foot injury in the performance of duty on February 3, 2011; and (2) whether OWCP properly denied his request for further merit review under 5 U.S.C. § 8128(a). 1 5 U.S.C. § 8101 et seq. FACTUAL HISTORY On February 23, 2011 appellant, then a 60-year-old letter carrier, filed a traumatic injury claim (Form CA-1) alleging that on February 3, 2011 he sustained a right foot and heel injury when he was walking his route and felt pain. He notified his supervisor on February 23, 2011. In medical reports dated February 8 to March 30, 2011, appellant’s attending physician, Dr. Marc Frankel, a podiatrist, reported that appellant complained of right heel foot pain, worse when he would step down, plantar medial, poststatic dyskinesia.
  • Plantar Fasciitis and Calcaneal Spur Formation Are Associated with Abductor Digiti Minimi Atrophy on MRI of the Foot

    Plantar Fasciitis and Calcaneal Spur Formation Are Associated with Abductor Digiti Minimi Atrophy on MRI of the Foot

    City University of New York (CUNY) CUNY Academic Works Publications and Research Brooklyn College 2008 Plantar fasciitis and calcaneal spur formation are associated with abductor digiti minimi atrophy on MRI of the foot Usha Chundru Maimonides Medical Center Amy Liebeskind Maimonides Medical Center Frank Seidelmann Franklin & Seidelmann Subspecialty Radiology Joshua Fogel CUNY Brooklyn College Peter Franklin Franklin & Seidelmann Subspecialty Radiology See next page for additional authors How does access to this work benefit ou?y Let us know! More information about this work at: https://academicworks.cuny.edu/bc_pubs/60 Discover additional works at: https://academicworks.cuny.edu This work is made publicly available by the City University of New York (CUNY). Contact: [email protected] Authors Usha Chundru, Amy Liebeskind, Frank Seidelmann, Joshua Fogel, Peter Franklin, and Javier Beltran This article is available at CUNY Academic Works: https://academicworks.cuny.edu/bc_pubs/60 Skeletal Radiol (2008) 37:505–510 DOI 10.1007/s00256-008-0455-2 SCIENTIFIC ARTICLE Plantar fasciitis and calcaneal spur formation are associated with abductor digiti minimi atrophy on MRI of the foot Usha Chundru & Amy Liebeskind & Frank Seidelmann & Joshua Fogel & Peter Franklin & Javier Beltran Received: 10 December 2007 /Revised: 6 January 2008 /Accepted: 7 January 2008 /Published online: 20 February 2008 # ISS 2008 Abstract presence of Achilles tendinosis (22.0% vs 3.0%, P<0.001), Objective To determine the association of atrophy of the calcaneal edema (15.0% vs 3.0%, P=0.005), calcaneal spur abductor digiti minimi muscle (ADMA), an MRI manifes- (48.0% vs 7.0%, P<0.001), plantar fasciitis (52.5% vs tation of chronic compression of the inferior calcaneal 11.0%, P<0.001), and PTTD (32.0% vs 11.0%, P<0.001).
  • Ultrasound Guidance Does Not Improve the Results of Shock Wave for Plantar Fasciitis Or Calcific Achilles Tendinopathy: a Randomized Control Trial Masiiwa M

    Ultrasound Guidance Does Not Improve the Results of Shock Wave for Plantar Fasciitis Or Calcific Achilles Tendinopathy: a Randomized Control Trial Masiiwa M

    Original Research Ultrasound Guidance Does Not Improve the Results of Shock Wave for Plantar Fasciitis or Calcific Achilles Tendinopathy: A Randomized Control Trial Masiiwa M. Njawaya, BMed, PGDipSportsMed,* Bassam Moses, MBBS, FRACGP,† David Martens, MBBS,‡ Jessica J. Orchard, LLB (Hons I), MPH,§ Tim Driscoll, MBBS, PhD,§ John Negrine, FRACS,{ and John W. Orchard, MD, PhD§ Abstract Objective: To establish whether the use of ultrasound to direct shock waves to the area of greater calcification in calcaneal enthesopathies was more effective than the common procedure of directing shock waves to the point where the patient has the most tenderness. Design: Two-armed nonblinded randomized control trial with allocation concealment. Setting: The Sports Clinic at Sydney University. Patients: Participants 18 years or older with symptomatic plantar fasciitis (PF) (with heel spur) or calcific Achilles tendinopathy (CAT). Seventy-four of 82 cases completed treatment protocol and 6-month follow-up. Interventions: Patients were randomized to receive either ultrasound-guided (UG) or patient-guided (PG) shock wave at weekly intervals over 3 to 5 weeks. Main Outcome Measures: Reduced pain on visual analog scale (VAS) and improved functional score on Maryland Foot Score (MFS) (for PF) or Victorian Institute of Sport Assessment-Achilles (VISA-A) (for CAT). Follow-up was at 6 weeks and 3 and 6 months. Results: Comparative 6-month improvements in MFS for the 47 PF cases were PG +20/100 and UG +14/100 (P 5 0.20). Comparative 6-month improvement in VISA-A score for the 27 CAT cases were PG +35/100 and UG +27/100 (P 5 0.37).
  • OITE Foot and Ankle Review Anatomy and Biomechanics

    OITE Foot and Ankle Review Anatomy and Biomechanics

    OITE Foot and Ankle Review Anatomy and Biomechanics • Bones and Ligaments – The Ankle Joint • Includes the Tibia, talus and fibula • Joint is trapezoidal and wider anteriorly • Talus only tarsal bone without muscular or ligamentous insertions – Lateral Ankle Ligaments • Anterior Talofibular Ligament (ATFL) – Under strain in plantar flexion, inversion, and Internal rotation • Calcaneofibular Ligament (CFL) – Under strain in dorsiflexion and inversion • Posterior Talofibular Ligament (PTFL) Anatomy and Biomechanics • Deltoid Ligament – Triangular shaped ligament with the apex at the medial malleolus and extending to the calcaneus, talus, and navicular – Divided into: • Superficial component – Three parts: anterior to navicular, inferior to sustanaculum, and posterior to talar body • Deep component – Two bands from medial malleolus to talar body just inferior to the medial facet • Syndesmosis – Ligamentous structures • Anterior inferior tibiofibular ligament (AITFL) • Interosseous ligament • Posterior inferior tibiofibular ligament • Transverse tibiofibular ligament Anatomy and Biomechanics • Hindfoot and Midfoot – Subtalar Joint • Three Facets: Posterior (Largest), Middle (medial and rests on sustenacum tali), and anterior (continuous with talonavicular joint) • Transverse Tarsal Joint (Chopart Joint) – Talonavicular and Calcaneocuboid Joints – Talonavicular Joint supported by two ligaments (Spring Ligament): the superior medial calcaneonavicular ligament (SMCN) and the inferior calcaneonavicular (ICN) ligament • Most likely attenuated in
  • The Plantar Fascia As a Source of Painfbiomechanics, Presentation and Treatment

    The Plantar Fascia As a Source of Painfbiomechanics, Presentation and Treatment

    ARTICLE IN PRESS Journal of Bodywork and Movement Therapies (2004) 8, 214–226 Journal of Bodywork and Movement Therapies www.intl.elsevierhealth.com/journals/jbmt PLANTAR HEEL PAIN SYNDROME: OVERVIEW AND MANAGEMENT The plantar fascia as a source of painFbiomechanics, presentation and treatment Simon J. Bartold* The University of South Australia, 202 Kensington Road, Marryatville, SA 5068, Australia Received 14 January 2003; received in revised form 6 August 2003; accepted 8 September 2003 KEYWORDS Abstract That plantar fasciitis is one of the most common causes of heel pain is Plantar fascia; beyond dispute. It is also by far the most common sports injury presenting to the Windlass mechanics; office of the sports podiatrist (Bartold, 2001, Sports Medicine for Specific Ages and Morning pain; Abilities. Churchill Livingstone, Edinburgh, p. 425) and accounts for approximately 15% of all foot related complaints (Lutter, 1997, Med. J Allina. 6(2) http:// Stretching; www.allina.com). The term plantar fasciitis itself has been responsible for Orthoses; considerable confusion, since the condition usually presents as a combination of Taping clinical entities, rather than the discrete diagnosis of plantar fasciitis. For this reason, it may be preferable to consider the condition a syndrome, and alter the nomenclature to plantar heel pain syndrome (PHPS). Despite its wide distribution in the sporting and general communities, there remains widespread debate on its aetiology and dissatisfaction with a lack of reliable treatment outcomes. This paper describes the unique anatomical and biomechanical features of plantar fasciitis which may in part explain its resistance to treatment. The history and physical examination are described along with potential differential diagnoses.
  • POSTERIOR CALCANEAL OSTEOTOMY: a Surgical Alternative for Chronic Retrocalcaneal Pain

    POSTERIOR CALCANEAL OSTEOTOMY: a Surgical Alternative for Chronic Retrocalcaneal Pain

    CHAPTER 3 POSTERIOR CALCANEAL OSTEOTOMY: A Surgical Alternative for Chronic Retrocalcaneal Pain Dennis E. Manin, DP.M. The patient who complains of pain and deformity in the posterior aspect of the calcaneus presents a challenge to the treating physician. Although exten- sively discussed in the medical literature, there is little agreement concerning the methods of treat- ment for this condition. Furthermore, significant ovedap exists between several similar clinical con- ditions in this location. Achilles tendoniris, paratenonitis, tenocalcinosis, Haglund's deformity, retrocalcaneal bursitis, and retrocalcaneal spur pain all have comparable clinical features. Successful treatment for these conditions will vary depending on the exact etiologic factors involved. This paper will address chronic pain associated with retrocal- caneal spurring and Achilles tendonitis, Figure 1. The posterior bursal projection of the calcaneus with or which will without spur fomation can become a sollrce of mechanical irritation be referred to as retrocalcaneal spur syndrome. with ankle joint dorsiflexion. ETIOLOGY Both static and dynamic factors may contribute to the development of retrocalcaneal spur syndrome. Static intrinsic factors, such as a ca\.us or cavo- varus foot type, can predispose the heel to abnormal pressures when combined with improper shoes. As the Achilles tendon and retrocalcaneal bursa become pinched between the hard posterior superolateral aspect of the calcaneus and the firm heel counter of the shoe, inflammation and degen- eration may occur. Although this process is commonly associated with the classic Haglund's deformity, it can also be seen as a complicating fac- Figure 2. Clinical appearance fbllolr.ing chronic tendonitis and tor in the retrocalcaneal spur syndrome.