Hi Everyone,
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I have an 84y.o female patient with medical history including L/Total hip replacement, Chronic back pain, osteoporosis, IBS and Asthma.
She presented to clinic with acute focal pain, erythema and swelling sub right 3rd MPJ, with a small ‘lump’ felt on palpation.
On assessment no obvious biomechanical abnormalities, however her footwear was less than desirable, due to narrow nature and shallow depth, making any offloading attempt difficult at best and with her unwillingness to change her footwear making it harder to treat.
DDX included acute bursitis, capsulitis, mortons neuroma.
At time of assessment I added a thin layer of slow release (red) poron lining into her shoes which made them more comfortable to walk in according to the patient.
I sent her off to have a Diagnostic Ultrasound and was a little shocked when the report came back with there being a 6mm long focal thrombosis in the vein within the subcutaneous fat layer overlying the plantar surface of the 3rd MPJ corresponding with the area of focal tenderness.
Is this common?
Have many people seen it before?
How is something like this usually managed?
Thanks,
Nick
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Usefulness of on demand or routine doppler -
ABPI
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Increased number of patients with shellac on their nails
>
<
Usefulness of on demand or routine doppler -
ABPI
|
Increased number of patients with shellac on their nails
>
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