Posts for: December, 2020
We are in the heart of winter and have now had our first snowstorm in NY. Although most people know to dress warm, we have to remind our patients that prolonged exposure in the cold can have some detrimental effects!
With prolonged exposure to cold weather, your feet are often the first part of the body to feel the uncomfortable effects. In an effort to keep our core body temperature stable, blood vessels within our arms and legs will narrow, which is why they're the first parts of our bodies to get cold when temperatures drop.
Frostbite damages body tissues in much the same way that burns do. In fact, frostbite injuries and burn injuries can look very similar. Early frostbite can be nearly indistinguishable from a burn. The damage to skin causes almost identical swelling and blisters at first.
You can't properly treat frostbite unless you recognize it. It's important to both recognize the symptoms of frostbite and know what to do if you experience symptoms.
Mild exposure to cold typically produces pain and irritation of the skin. Greater exposure may produce burning and numbness as well as blistering and reversible damage to the outer skin layers. Eventually, there will be complete loss of sensation and permanent damage to all layers of the skin, arteries, muscles and tendons. Gangrene can ensue and various amputations may be required due to the irreversible damage to the tissues.
If you suffer from peripheral neuropathy and have poor sensation to your feet, be extra careful as you may not identify the early symptoms.
If you’ve had prolonged exposure in the cold do not hesitate to present to the doctor quickly so we can identify the problem and begin treating you! Stay safe everyone.
Ganglion cysts are the most common soft tissue masses of the foot and ankle. Although they are benign, they can cause significant pain and disability. They form when the fluid which surrounds tendons and joints leaks out and creates a fluid-filled mass. They may be associated with trauma, overuse, or sometimes just bad luck! Patients may notice that the cyst changes in size, especially with physical activity.
In the 19th and early 20th centuries, treatment involved trying to flatten the cyst by hitting it with a large textbook or bible. Suffice it to say, treatment of ganglion cyst has evolved! First line management involves imaging the mass by obtaining x-rays, ultrasound, or possibly an MRI. If the mass is large enough it may be aspirated in the office. This involves using a needle to remove the fluid from the mass. Alternatively, the area can be anesthetized, a small incision can be made, and the fluid can be evacuated in the office. Patients who have larger, reoccurring cysts may need surgical consultation so that the cyst be removed in its entirety in the operating room.
Below is an example of a large ganglion cyst. The patient presented to our office with a large mass around the tendons of her foot. In fact, the mass was so large that the patient was experiencing numbness in her toes because the mass was compressing the nerves of her foot. A physical exam and in-office ultrasound of the area were consistent with ganglion cyst. After the foot was anesthetized, a small incision was made and the mass was drained. One day following the procedure the patient was pain free and the numbness in her toes completely subsided.
Although they are benign, ganglion cysts can cause a myriad of symptoms and should be evaluated by one of the doctors of our practice as soon as possible.