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Os Trigonum vs Gouty Arthritis

Gout as a differential diagnosis for os trigonum syndrome in adolescent patientsMRI - Os trigonum

Posterior ankle pain in the adolescent patient population is a relatively uncommon complaint.  What is the differential diagnosis for posterior ankle pain in the adolescent population?  Most clinicians would not consid...

Posterior Ankle Pain – Differential Diagnosis

What are the causes of posterior ankle pain?Nerves of the lower extremity

One of my peers came to me the other day at the hospital and asked me about a pain she was having in the back of the ankle.  She stated that she had had plain films taken that were unremarkable.  She also had an MRI that failed to show any bone edema, ar...

Tarsal Tunnel Syndrome and the Tinel’s Sign

Is the Tinel’s sign a reliable diagnostic test?Testing for Tinel's sign of the posterior tibial nerve

Tarsal tunnel syndrome describes an entrapment of the posterior tibial nerve at the medial aspect of the ankle.  The posterior tibial nerve descends the leg and splits into three branches.

  • First branch – supplies sensation to the plantar heel.  Als...
External Fixation for Charcot Joint Reconstruction

Patient choice – are there weight limits when using ex-fix?Charcot reconstruction

External fixation (ex-fix) is often used as an adjunct to internal fixation when correcting rocker bottom flat foot due to Charcot arthropathy.  The reason that ex-fix is used is that the frame, or ex-fix device, can be used to carry weigh...

Carbon graphite insoles and gait

Levers, rockers and carbon graphite insoles

Part 3 – Putting it all together

In part 1 of this conversation I presented a common customer question:  can I wear just one carbon fiber insole?  I briefly discussed gait and how a carbon fiber insole may affect gait.  In part 2 of this conversation I a...