AMERICAN COLLEGE OF FOOT & ANKLE ORTHOPEDICS & MEDICINE Review Text in Podiatric Orthopedics and Primary Podiatric Medicine edited by Annemarie A. Edwards, DPM, FACFAOM, FACFAS Intermountain Health Care Physician Division Department of Veterans Affairs Medical Center Podiatric Medicine and Surgery Assistant Residency Director Externship Director Salt Lake City, UT John H. Walter, Jr., DPM, MS, FACFAOM, FACFAS Chairman and Professor, Department of Podiatric Orthopedics and Biomechanics, Temple University School of Podiatric Medicine, Philadelphia, PA Faculty, Department of Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA Podiatric Orthopedic Residency Director, Temple University School of Podiatric Medicine, Philadelphia, PA Larry R. Goss, DPM, FACFAOM, FACFAS, FAPWCA Adjunct Clinical Instructor, Department of Podiatric Orthopedics and Biomechanics, Temple University School of Podiatric Medicine, Philadelphia, PA Director of Podiatric Surgical Residency, Tenet Roxborough Memorial Hospital, Philadelphia, PA Attending Staff, The WorldWalk Foundation, Bala Cynwyd, PA Private Practice, Philadelphia Foot and Ankle, PC, Bala Cynwyd, PA Copyright © 2004 American College of Foot & Ankle Orthopedics & Medicine All rights reserved, Second Edition Manufactured in the United States of America Published by American College of Foot & Ankle Orthopedics & Medicine 5272 River Road, Suite 630 Bethesda, MD 20816 800-265-8263 ISBN 0-9764122-0-9 CONTENTS Contributors ......................................................................................................................................... i Foreword .......................................................................................................................................... vii About ACFAOM ................................................................................................................................ix Chapter 1 Imaging/Radiology ........................................................................................................ 1 Chapter 2 Laboratory Medicine ................................................................................................... 55 Chapter 3 Pharmacology.............................................................................................................. 75 Chapter 4 Neurology ..................................................................................................................121 Chapter 5 Trauma to the Foot and Ankle .....................................................................................149 Chapter 6 Physical Medicine and Rehabilitation, Orthotics, and Prosthetics ................................243 Chapter 7 Biomechanics .............................................................................................................281 Chapter 8 Sports Medicine..........................................................................................................311 Chapter 9 Surgical Criteria and Complications ............................................................................337 Chapter 10 Anesthesia ..................................................................................................................377 Chapter 11 Emergency Medicine ..................................................................................................393 Chapter 12 Cutaneous Signs in the Diagnosis of Skin Lesions of the Foot .....................................407 Chapter 13 Rheumatology ............................................................................................................441 Chapter 14 Peripheral Vascular Disease ........................................................................................473 Chapter 15 Infectious Disease and Wound Care of the Lower Extremity .......................................489 Chapter 16 Soft Tissue Tumors and Skin Neoplasms .....................................................................517 Chapter 17 Osseous Neoplasms ....................................................................................................547 Chapter 18 Diabetes Mellitus ........................................................................................................577 Chapter 19 General Pediatrics .......................................................................................................593 Chapter 20 Common Pediatric Deformities ...................................................................................607 Chapter 21 Community Medicine, Biostatistics, Epidemiology, Evidence Based Medicine and Geriatrics ..............................................................................................617 Chapter 22 Common Foot Problems in the Older Patient Diagnostic and Therapeutic Considerations .........................................................................................639 Index ...............................................................................................................................................651 iii iv CONTRIBUTORS EDITORS Annemarie A. Edwards, DPM, FACFAOM, FACFAS Intermountain Health Care Physician Division Department of Veterans Affairs Medical Center Podiatric Medicine and Surgery Assistant Residency Director Externship Director Salt Lake City, UT John H. Walter, Jr., DPM, MS, FACFAOM, FACFAS Chairman and Professor, Department of Podiatric Orthopedics and Biomechanics, Temple University School of Podiatric Medicine, Philadelphia, PA Faculty, Department of Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA Podiatric Orthopedic Residency Director, Temple University School of Podiatric Medicine, Philadelphia, PA Larry R. Goss, DPM, FACFAOM, FACFAS, FAPWCA Adjunct Clinical Instructor, Department of Podiatric Orthopedics and Biomechanics, Temple University School of Podiatric Medicine, Philadelphia, PA Director of Podiatric Surgical Residency, Tenet Roxborough Memorial Hospital, Philadelphia, PA Attending Staff, The WorldWalk Foundation, Bala Cynwyd, PA Private Practice, Philadelphia Foot and Ankle, PC, Bala Cynwyd, PA CONTRIBUTORS Robert L. Baron, DPM, FACPR, FACFAOM Professor and Chairman, Department of Radiology, Scholl College of Podiatric Medicine at Finch University/Chicago Medical School Private Practice, Oswego, IL v Jason Bruse, DPM, FACFAS Submitted while Senior Podiatric Surgical Resident, Department of Veterans Affairs Medical Center, Salt Lake City, UT Podiatric Surgery Intermountain Health Care Physicians Division Endocrine, Diabetes, and Podiatry Clinic, Ogden, UT Cindy Bullock, DPM Senior Podiatric Surgical Resident, Department of Veterans Affairs Medical Center, Salt Lake City, UT Denise B. Freeman, DPM, MSE, ABPOPPM, FACFAOM, FACFAS Associate Professor, College of Podiatric Medicine and Surgery, Des Moines University - Osteopathic Medical Center Director, Podiatric Orthopedic Residency Program, College of Podiatric Medicine and Surgery, Des Moines University Osteopathic Medical Center Coordinator, Lower Extremity Biomechanics Course, College of Podiatric Medicine and Surgery, Des Moines University - Osteopathic Medical Center Coordinator, Clinical Biomechanics Course, College of Podiatric Medicine and Surgery, Des Moines University - Osteopathic Medical Center Alexandra Grulke, DPM Podiatric Surgical Resident, Temple University Hospital, Philadelphia, PA Arthur E. Helfand, DPM, DABPOPPM, DABPPH Professor Emeritus, Temple University School of Podiatric Medicine, Philadelphia, PA Retired Chair, Department of Community Health, Aging, and Health Policy Honorary Staff, Temple University Hospital Honorary Staff, Thomas Jefferson University Hospital Consultant, Temple University Institute on Aging Past President, American Podiatric Medical Association Past President, American Board of Podiatric Orthopedics Past President, American Board of Podiatric Public Health Erwin J. Juda, DPM, RPH, FACFAOM Private Practice, Christiana, DE Assistant Professor, Department of Podiatric Medicine, Temple University School of Podiatric Medicine, Philadelphia, PA Franklin Kase, DPM, FACFAOM, FACFAS, ABPOPPM, FAAPSM Chief of Podiatric Surgery, Glendale Memorial Hospital, Glendale, CA Podiatric Medicine Director, Wound Care Center, Glendale Memorial Hospital, Glendale, CA Peer Review and Insurance and Patient Relations Committee, California Podiatric Medical Association vi Podiatric Consultant, Burbank High School, Burroughs High School, Glendale College, Occidental College, Los Angeles Police Department, Los Angeles Fire Department, Verdugo Hills Gymnastic Club Medical Advisory Board, Southern California Association of Occupational Health Nurses QME (Qualified Medical Examiner), California State Industrial Medical Council Expert Witness, Board of Podiatric Medicine, State of California AME (Agreed Medical Examiner) President, California Podiatric Medical Association Podiatric Consultant to the Los Angeles Olympic Committee P.R. Krishna, MD, MS, FICS Harvey Lemont, DPM, FASCP Director, Foot Dermatology Clinic, Temple University School of Podiatric Medicine, Philadelphia, PA Director, Laboratory of Podiatric Pathology, Philadelphia, PA Todd C. Loftus, DPM, FACFAS Submitted while Chief Podiatric Surgical Resident, Department of Veterans Affairs Medical Center, Salt Lake City, UT Private Practice, Columbus, OH Ralph E. Marcus, MD, FACR Chief Rheumatology Section, Holy Name Hospital, Teaneck, NJ Associate Professor of Medicine, The University of Medicine & Dentistry of NJ Robert Wood Johnson Medical School, New Brunswick, NJ Robert