Diagnostics in Sugar Land
Houston Area Podiatry Services
X-rays of the hand, wrist, arm, foot, ankle, knee, or leg help determine
whether a bone has been fractured or injured or damaged by conditions
such as an infection, arthritis, or other disease.
Other reasons for conventional X-rays on your feet include:
- Evaluate changes in the bones caused by such things as an infection, arthritis,
or other bone disease.
- Help evaluate whether a child`s bones are growing normally.
- Locate foreign objects (such as pieces of glass or metal) in a wound.
- To determine whether bones are properly set after treating a fracture and
placing a cast on an arm or leg.
Pregnant women, especially those in their first trimester, are advised
against having a CT exam or any X-ray examination. Extremity X-rays usually
takes only five to 10 minutes.
While extremity X-rays do a good job showing bone fractures or dislocations,
they are not very accurate when it comes to showing affected cartilage,
tendons, or ligaments. A MRI or CT scan may be prescribed.
Musculoskeletal ultrasonography is a very powerful diagnostic tool for
the diagnosis of wide array of foot and ankle problems. At Advanced Foot
and Ankle Specialists an ultrasound may be performed in the office to
help diagnose your foot problem. We use ultrasound typically for soft
tissue problems, not bone conditions. Typically the scan is performed
by the doctor.
Some of the foot and ankle disorders that ultrasound may be used for are
- Foreign bodies
- Morton's neuroma
- Soft tissue masses
- Bursitis or capsulitis of the joints
- Ligament injuries
- Tendinitis or tendon tears
- Heel spurs or plantar fasciitis
- Tarsal tunnel syndrome
- Ultrasound guided injection or aspirations
What is Ultrasound?
Most people know about ultrasound to image a baby or a gallbladder, but
it has growing application in musculoskeletal disorders. Ultrasound is
based on sound waves. Sound waves are emitted from a transducer probe
that is applied to the body and these sound waves will past into the body
and then are reflected back to the transducer probe to be recorded. The
recorded image is based on the density of the object that the sound waves
encounter. An object with a high density appears white or brighter on
the recorded image, while objects of low density will appear black or
dark on the image. Intermediate densities will appear gray. The sound
waves are recorded back to the machine, which will produce the image.
This image will appear on our ultrasound screen and you the patient can
immediately see the area that the doctor is scanning and help to understand
the problem you are having. This helps in directing the appropriate treatment
for your condition.
Ultrasound is completely safe and painless. It also has no contraindications.
There is no problem in having the examination if you are pregnant, have
a pacemaker or other medical conditions that may prevent you from having
a MRI or CT scan. Ultrasound also does not produce any radiation as with
a CT scan or x-rays.
In preparing for the examination, you can eat and take your normal medications.
The examination will take from 45 minutes to an hour based on the area
being scanned. It is advised that you bathe the day of the examination
but avoid the use of any skin lotions or emollients. Also you should where
loose fitting clothing or shorts to make it easier to perform the examination.
Extracorporeal Shockwave (ESWT)
New Treatment Available for Heel Pain/Achilles Tendinitis
What is ESWT?
Extracorporeal shockwave treatment, also known as ESWT, is a non- invasive,
non-surgical treatment option for the intense, persistent heel pain associated
with chronic plantar fasciitis and achilles tendinitis. "Extracorporeal"
means "outside the body". Shockwaves, also known as pressure
or sound waves, are generated from a special ESWT device and focused onto
the targeted tissue. The shockwaves are delivered outside the body to
trigger an individual's own repair mechanisms. The concept behind
shockwave therapy in orthopedic disorders is that the shockwave stimulates
and reactivates healing to encourage revascularization and other elements
necessary to advance normal tissue healing. Additionally, shockwaves help
to over-stimulate pain transmission nerves, which can lead to a reduction
in sensitivity and pain.
The doctors at Advanced Foot and Ankle Specialists have been performing
ESWT since 2003 and is now available as an in-office procedure.
What is plantar fasciitis?
The plantar fascia is a band of connective tissue on the plantar surface
of the heel that plays a large role in maintaining the normal architecture
of one's foot. Plantar fasciitis is a common clinical condition caused
by overuse or injury of the plantar fascia and is defined as traction
degeneration of the plantar fascial band at its origin on the medial tubercle
of the calcaneus. Inflammation, fibrosis, and decreased vascularization
of the fascia occur, causing symptoms of heel pain. Other symptoms that
may occur include burning in the sole of the foot, recurring foot pain
that is especially aching in the morning or after sitting, or heel pain
after beginning a new exercise routine.
What causes plantar fasciitis?
There are a number of predisposing factors, including foot pronation, obesity,
poor fitting shoes, minor trauma, occupational risks and change in exercise
program. Although everyone is at risk, plantar fasciitis is most commonly
found in athletes, runners, overweight individuals, or those who are required
to stand on hard surfaces for prolonged periods of time. Although approximately
2,000,000 Americans suffer from plantar fasciitis. ESWT is an appropriate
treatment option in approximately 5 to 10% of those cases, as the remainder
of the cases can be adequately addressed with more conservative therapies.
Who should receive ESWT for plantar fasciitis?
Prior to undergoing ESWT treatment, the patient must have been diagnosed
with chronic plantar fasciitis for at least six months. Only after the
patient's symptoms fail to respond to three conservative treatments
should ESWT be administered. Conservative treatments include rest, physical
therapy, heel cushions, non-steroidal anti-inflammatory drugs (ibuprofen,
acetaminophen, etc), cortisone injections, taping, orthotics, shoe modifications,
night splinting and casting. In years past, surgical intervention for
chronic plantar fasciitis was required when these other treatments had
failed. Today, ESWT is available as an alternative, non-invasive treatment option.
Who should not receive ESWT treatment for plantar fasciitis?
Your health history should be reviewed with your doctor to see if this
treatment is appropriate for you. ESWT is not recommended for patients
with certain conditions. Patients with pacemakers and patients taking
medications that may prolong or interfere with blood clotting (coumadin)
are not candidates for ESWT. Also, children or pregnant women are not
considered appropriate candidates for ESWT. ESWT is not appropriate for
individuals suffering from acute plantar fasciitis.
What are the side effects of ESWT?
Compared to surgery, ESWT has fewer side effects and a much shorter recovery
time. The most common patient complaint is some minor pain or discomfort
during and after treatment. Other side effects might include minor skin
bruising, reddening, or swelling of the treated area. However, these possible
occurrences usually resolve within a few days. The risks associated with
surgery and general anesthesia are eliminated.
All Advanced Foot and Ankle Services locations are furnished with state
of the art autoclaves for the sterilization of instruments for minor procedures
- Nail Surgery
- Cyst Removal
- Skin Biopsy
- Soft Tissue Removal
- Minor Bone Surgery
- Treatment of Wounds
- Tissue Repair from Trauma