Use of the Tissue Stress Model as a Paradigm for Developing an Examination and Management Plan for a Patient with Plantar Fasciitis

2002 ◽  
Vol 92 (9) ◽  
pp. 499-506 ◽  
Author(s):  
Michael Ross
Keyword(s):  
Case Report ◽  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Management Plan ◽  
Stress Model ◽  
Patient History ◽  
Stress Treatment ◽  
Patient Reported ◽  
History Of

This case report demonstrates the use of the tissue stress model to develop an examination, evaluation, and management plan for a patient with an 8-week history of plantar fasciitis. The patient history focused on determining which tissues were being excessively stressed, and the physical examination was used to apply controlled stresses to these tissues and to determine factors contributing to the patient’s condition. After it was confirmed that the patient’s plantar fascia was under excessive mechanical stress, treatment first focused on reducing pain, inflammation, and stress on the plantar fascia and then on returning the patient to her running program while maintaining symptoms at a diminished level. The patient reported being free of pain 7 weeks after the initial physical therapy examination and at the 11-week telephone follow-up. Although no experimental evidence is given, this report suggests that this patient responded positively to treatment based on the tissue stress model. (J Am Podiatr Med Assoc 92(9): 499-506, 2002)

Iatrogenic Lateral Plantar Nerve Injury After Endoscopic Plantar Fascia Release: A Case Report

2020 ◽  
Vol 110 (6) ◽  
Author(s):  
Yen-Chun Chiu ◽  
Shih-Chieh Yang ◽  
Yu-Hwan Hsieh ◽  
Yuan-Kun Tu ◽  
Shyh-Ming Kuo ◽  
...  
Keyword(s):  
Case Report ◽  
Nerve Injury ◽  
Endoscopic Surgery ◽  
Plantar Fasciitis ◽  
Surgical Intervention ◽  
Plantar Fascia ◽  
Slight Improvement ◽  
Lateral Plantar Nerve ◽  
Plantar Fascia Release

We present a 57-year-old female patient with iatrogenic lateral plantar nerve injury caused by endoscopic surgery for plantar fasciitis. Nerve grafting surgery was recommended, but the patient refused further surgical intervention because of personal reasons. After 1-year follow-up in outpatient clinics, she achieved only slight improvement in the lateral foot symptoms and still required oral analgesics for pain control. The purpose of this case report is to remind physicians of such a rare and serious complication that can occur after endoscopic surgery for plantar fasciitis. Good knowledge of anatomy and skilled surgical technique could decrease this type of complication.

Ultrasonographic Evaluation of Low Energy Extracorporeal Pulse Activated Therapy (EPAT) for Chronic Plantar Fasciitis

2012 ◽  
Vol 33 (3) ◽  
pp. 202-207 ◽  
Author(s):  
Robert Gordon ◽  
Charles Wong ◽  
Eric J. Crawford
Keyword(s):  
Plantar Fasciitis ◽  
Case Series ◽  
Plantar Fascia ◽  
Ultrasound Measurement ◽  
Level Of Evidence ◽  
Pain Scores ◽  
Ultrasound Evaluation ◽  
Patient Reported ◽  
History Of ◽  
Minimum Followup

Background: Ultrasonographic measurement of the plantar fascia can be used to objectively diagnose plantar fasciitis. The purpose of this study was to determine the long-term effectiveness of Extracorporeal Pulse Activated Therapy (EPAT) for the treatment of plantar fasciitis using ultrasonographic measurement as an objective outcome measure, with a minimum followup of 12 months. Methods: Patients with chronic recalcitrant plantar fasciitis were prospectively recruited and underwent EPAT. Ultrasound measurement of the plantar fascia and patient-rated pain scores were collected before treatment and at followup (minimum of 12 months post-treatment). Twenty-five subjects (35 feet) met the inclusion criteria. The average followup time was 29.4 ± 13.1 (M ± SD; range, 12 to 54) months. Results: The average thickness of the plantar fascia of the symptomatic heels was 7.3 ± 2.0 mm before treatment and 6.0 ± 1.3 mm after treatment ( p < 0.001). The average change in thickness of the treated heels was −1.3 mm (−0.8 to −1.8 mm; 95% CI, p < 0.0001). No correlation was found between length of followup and change in ultrasound measured plantar fascia thickness ( r = −0.04, p = 0.818). Conclusion: For patients with a greater than 12-month history of heel pain, EPAT can effectively decrease plantar fascia thickness as demonstrated objectively by ultrasound evaluation and reduce patient-reported pain. No relationship between length of followup and change in plantar fascia thickness was found after 12 months. Level of Evidence: IV; Case Series

scholarly journals The spontaneous resolution of a vortex vein varix: case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara L Weidmayer ◽  
Hakan Demirci
Keyword(s):  
Case Report ◽  
Natural History ◽  
Extended Period ◽  
Spontaneous Resolution ◽  
Case Presentation ◽  
Clinical Resolution ◽  
History Of ◽  
Vortex Vein ◽  
Insight Into

Abstract Background The natural course of a vortex vein varix, though not well understood, has been known to remain stable. However, here we report a novel case of a vortex vein varix that resolved after an extended period of monitoring. Case presentation An asymptomatic 96-year-old Caucasian man was found to have a vortex vein varix. At his previous examination 13 months prior, his fundus was normal. At 13 months of observation, his vortex vein varix become clinically undetectable. Further follow-up confirmed continued absence of the varix. Conclusion This case demonstrates the development then clinical resolution of a vortex vein varix with no clear identifiable factors for its evolution. This case is novel and offers new insight into the natural history of some vortex vein varices, implicating venous congestion as an instigator and venous collateralization as its alleviator, suggesting that vortex vein varices are likely more common than previously reported since some may be temporary and under-identified.

scholarly journals Sialendoscopy With Intraductal Steroid Irrigation in Patients With Sialadenitis Without Sialoliths

2019 ◽  
Vol 98 (5) ◽  
pp. 291-294 ◽  
Author(s):  
Saudamini J. Lele ◽  
Mickie Hamiter ◽  
Torrey Louise Fourrier ◽  
Cherie-Ann Nathan
Keyword(s):  
Treatment Option ◽  
Case Series ◽  
Complete Response ◽  
Definitive Treatment ◽  
Invasive Technique ◽  
Effective Treatment Option ◽  
Patient Reported ◽  
History Of ◽  
The Mean

Sialendoscopy has emerged as a safe, effective and minimally invasive technique for management of obstructive and inflammatory salivary gland disease. The aim of our study was to analyze outcomes of sialendoscopy and steroid irrigation in patients with sialadenitis without sialoliths. We performed a retrospective analysis of patients who underwent interventional sialendoscopy with steroid irrigation from 2013 to 2016, for the treatment of sialadenitis without sialolithiasis. Twenty-two patients underwent interventional sialendoscopy with ductal dilation and steroid irrigation for the treatment of sialadenitis without any evidence of sialolithiasis. Conservative measures had failed in all. Eleven patients had symptoms arising from the parotid gland, 4 patients had symptoms arising from the submandibular gland, while 6 patients had symptoms in both parotid and submandibular glands. One patient complained of only xerostomia without glandular symptoms. The mean age of the study group which included 1 male and 21 females was 44.6 years (range: 3-86 years). Four patients had autoimmune disease, while 7 patients had a history of radioactive iodine therapy. No identifiable cause for sialadenitis was found in the remaining 11 patients. The mean follow-up period was 378.9 days (range: 16-1143 days). All patients underwent sialendoscopy with ductal dilation and steroid irrigation. Twelve patients showed a complete response and 9 patients had a partial response, while 1 patient reported no response. Only 3 patients required repeat sialendoscopy. The combination of sialendoscopy with ductal dilation and steroid irrigation is a safe and effective treatment option for patients with sialadenitis without sialoliths refractory to conservative measures. Prospective studies with a larger case series are needed to establish its role as a definitive treatment option.

scholarly journals Conjunctival Chemosis Caused by Exposure of the Lacrimal Caruncle: A Case Report

2017 ◽  
Vol 8 (1) ◽  
pp. 120-123
Author(s):  
Akinori Baba ◽  
Hiromichi Matsuda ◽  
Takuya Shiba ◽  
Yasuhiro Takahashi ◽  
Hiroshi Tsuneoka
Keyword(s):  
Case Report ◽  
Eyelid Closure ◽  
History Of

An 84-year-old woman presented with a 3-month history of conjunctival chemosis in the left eye. At the first examination, the chemosis neighbored the lacrimal caruncle and was localized in the inferomedial region of the conjunctiva. During eyelid closure, only the left lacrimal caruncle was exposed. One month later, the chemosis further extended to the inferolateral region. We debulked the lacrimal caruncle to prevent the exposure of the caruncle. One month after the surgery, conjunctival chemosis had resolved completely. At the postoperative 6-month follow-up, the patient showed no recurrence of chemosis.

scholarly journals Fibrous Epulis Misdiagnosed for Combined Periodontic-Endodontic Lesion

2017 ◽  
Vol 6 (2) ◽  
pp. 1546
Author(s):  
Nabil Khzam ◽  
Reza Shah Mansouri ◽  
Alexander Poli ◽  
Mahmoud M. Bakr
Keyword(s):  
Periodontal Disease ◽  
Excisional Biopsy ◽  
Osseous Metaplasia ◽  
Ossifying Fibroma ◽  
Peripheral Ossifying Fibroma ◽  
Periodontal Debridement ◽  
Patient Reported ◽  
History Of ◽  
Chronic Irritation

Fibrous epulis or peripheral ossifying fibroma is a reactive non-neoplastic condition that affects the gingiva as a result of chronic irritation. A case of a 44 year old female is presented in this study with a gingival swelling related to the maxillary central incisors. The Patient reported a history of trauma ten years ago and a recent root canal treatment of tooth 21, followed by referral to a specialist with a misdiagnosis for a combined periodontic-endodontic lesion affecting the maxillary central incisors. Excisional biopsy of the lesion revealed a diagnosis of ulcerated fibrous epulis with osseous metaplasia also known as peripheral ossifying fibroma. Periodontal debridement was performed to eliminate supra and subgingival plaque and calculus as well as gingival inflammation that could have been the source of irritation. The clinical and histopathological pictures and the surgical procedures associated with management of the periodontal disease are described. The etiological factor behind the development of the gingival reactive lesion remains unknown and could be the history of trauma, the chronic irritation induced by the plaque and calculus associated with the periodontal disease or a combination of both. We endeavour to follow up the case in order to report any recurrence.

scholarly journals “This Is Not the Original Timeline”: A Case Report of an Extended Dissociative Episode in a Healthy Young Male Accompanied with Severe Decline in Mental State

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Godwin Tong ◽  
Kieran Groom ◽  
Louisa Ward ◽  
Muhammad Naeem
Keyword(s):  
Case Report ◽  
Mental State ◽  
Young Male ◽  
Obsessive Compulsive ◽  
Psychiatric Admission ◽  
Compulsive Disorder ◽  
Psychiatric Setting ◽  
Patient Reported ◽  
History Of ◽  
Core Symptoms

Dissociation is a disconnection between a person’s thoughts, memories, feelings, actions, or sense of who he or she is. Dissociative disorders can be described and understood using the combination of five core symptoms: amnesia, depersonalisation, derealisation, identity confusion, or identity alteration. They are frequently associated with previous experience of trauma. The challenge in diagnosis and the lifetime prevalence of approximately 10% in the general population and clinical psychiatric setting ensures the relevance of this case. We write about a 21-year-old gentleman with history of autism and obsessive compulsive disorder, but no significant medical history was presented to the emergency department with increased anxiety, subsequently progressing to agitation, pacing, and becoming nonverbal. No significant findings were uncovered on laboratory blood testing (other than prolactin 737 mu/L and phosphate 0.35 mmol/L), lumbar puncture, or brain imaging. Consequently, he was admitted to a psychiatric unit for assessment. The patient continued to present with severe disorientation, limited speech, and altered state of consciousness with occasional spastic-like movements. Antipsychotic and benzodiazepine medication was initiated, with no significant change in presentation. The patient continued to be witnessed wandering and having incoherent speech. First signs of improvement came 21 days postadmission with brief conversation and lucidity. This continued to improve over the next 7 days where he was reported to be at his baseline mental state. Environmental stressors including university examinations, the COVID-19 pandemic, and recent contact with his estranged father were possible precipitants to the episode. The patient reported almost complete unawareness of the psychiatric admission. A diagnosis of dissociative disorder, unspecified, was given. This case shows the management and diagnostic challenges of patients presenting with the aforementioned symptoms. There are no formal guidelines for the management of treating dissociative episodes, and this case report suggests the possible benefits of a drug-free period of watchful waiting upon admission.

Abdominal intercostal hernia and costal arch repair

2021 ◽  
Vol 14 (11) ◽  
pp. e247189
Author(s):  
Jacob Moneim
Keyword(s):  
Case Report ◽  
Hernia Repair ◽  
Total Arthroplasty ◽  
Costal Arch ◽  
Intercostal Hernia ◽  
History Of ◽  
Abdominal Intercostal Hernia ◽  
Fat Herniation ◽  
Diaphragmatic Hernia Repair

A 70-year-old asthmatic man presented with a history of chronic intermittent left-sided chest pains and a bulge-like deformity of his chest which became more prominent with expiration. He sustained a traumatic fall 2 years prior whereby he fractured his right humerus at the surgical neck, requiring total arthroplasty. Examination and CT imaging of the thorax revealed a left costal arch fracture with hemidiaphragm rupture and associated transperitoneal fat herniation. He underwent left thoracolaparotomy with costal arch and diaphragmatic hernia repair. He was discharged 48 hours postoperatively and is satisfied with good outcomes under initial follow-up. This case report highlights the surgical management of a condition that usually presents late after significant trauma and may progress to visceral strangulation if untreated.

scholarly journals The effect of high-intensity versus low-level laser therapy in the management of plantar fasciitis: randomized participant blind controlled trial

2020 ◽  
Vol 34 (8) ◽  
pp. 1072-1082
Author(s):  
Dovile Naruseviciute ◽  
Raimondas Kubilius
Keyword(s):  
Laser Therapy ◽  
Plantar Fasciitis ◽  
Analogue Scale ◽  
Controlled Trial ◽  
Plantar Fascia ◽  
Time Frame ◽  
Low Level Laser Therapy ◽  
Level Laser ◽  
Significant Difference

Objectives: To evaluate and compare the efficacy of high-intensity laser therapy (HILT) and low-level laser therapy (LLLT) for plantar fasciitis. Design: A participant blind randomized controlled trial with parallel group design and an active comparator with follow-up at four weeks. Settings: Outpatient, University hospital. Subjects: Unilateral plantar fasciitis participants ( n = 102) were randomly assigned into two groups. Recruitment period was from January 2017 to April 2019. Interventions: Interventions included eight sessions of laser therapy over three weeks and single session of patient education. The HILT group ( n = 51) received HILT and the LLLT group ( n = 51) received LLLT. Main measures: Primary outcomes: visual analogue scale; secondary outcomes: pressure algometry, sonography of plantar fascia thickness (time frame: baseline to three-week and four-week follow-up) and numeric rating scale (0%–100%) for opinion of participants on effect of treatment (time frame: three weeks). Data presented: mean (SD) or n (%). Results: There was no statistically significant difference between the groups according to visual analogue scale (pain in general reduction in three weeks: 2.57(3.45) vs. 2.88(3.28) cm), pressure algometry (pain threshold difference between healthy and affected heel reduction in three weeks: 1.80(6.39) vs. 1.77(2.85) kg) and sonography measurements (plantar fascia thickness difference between healthy and affected heel reduction in three weeks: 0.19(0.56) vs. 0.30(0.57) mm). There was a statistically significant difference between the groups in participants’ opinion in favor to HILT group (efficacy of treatment better than 50%: 26(51%) vs. 37(73%)). Conclusion: No statistically significant difference between groups was observed.

scholarly journals Asystole in an older patient with recurrent falls. Case report

Case reports ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. 77-83
Author(s):  
William Fernando Bautista-Vargas
Keyword(s):  
Case Report ◽  
Older Patients ◽  
Implantable Devices ◽  
Loop Recorder ◽  
General Terms ◽  
Recurrent Falls ◽  
History Of ◽  
Rule Out

Introduction: Recurrent falls are a usual problema in older patients. It is therefore important to learn how to differentiate a pathological or syncopal episode from a simple stumbling fall, especially in patients who have limitations for communicating clearly and are poorly understood, in general terms, during the medical consultation. Implantable loop recorders (ILR) have been used as an investigation tool in selected cases of recurrent falls in older patients. Consequently, this case report aims to describe its usefulness in this type of patients.Case presentation: An 87-year-old female patient, hypertensive, with a history of recent stroke and frequent falls —referred to as stumbling—, received an implantable loop recorder due to atrial fibrillation. During one follow-up appointment, a 36-second pause related to a fall was documented, so a bicameral pacemaker was implanted.Conclusions: Evaluating repeated falls in older patients is complex; it must be done in detail to rule out syncopal episodes. Implantable devices to diagnose arrhythmic causes are useful and allow achieving accurate diagnoses and establish specific behaviors aimed at improving the quality of life of patients.

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