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At least since the time of Hippocrates, clubbing has been recognized as a sign of disease. [5] The phenomenon has been called "Hippocratic fingers". Self-portrait by Dick Ket showing nail clubbing. The Dutch painter Dick Ket had nail clubbing as is seen from his paintings. He had an underlying disease, probably dextrocardia. [17]
Although counterintuitive, pain is present in many cases despite the neuropathy. Some sort of trauma or microtrauma is thought to initiate the cycle but often patients will not remember because of numbness. Misdiagnosis is common. [1] The goal of treatment is to avoid ulceration, create joint stability, and to maintain a plantigrade foot. [1]
Peripheral neuropathy may be classified according to the number and distribution of nerves affected (mononeuropathy, mononeuritis multiplex, or polyneuropathy), the type of nerve fiber predominantly affected (motor, sensory, autonomic), or the process affecting the nerves; e.g., inflammation (), compression (compression neuropathy), chemotherapy (chemotherapy-induced peripheral neuropathy).
In 1982 Lewis et al. reported a group of patients with a chronic asymmetrical sensorimotor neuropathy mostly affecting the arms with multifocal involvement of peripheral nerves. [47] Also in 1982 Dyck et al reported a response to prednisolone to a condition they referred to as chronic inflammatory demyelinating polyradiculoneuropathy. [ 48 ]
The foot must have the ability to dorsiflex to at least 10 degrees past 0 (neutral, or L position), although 15 degrees or more is better and preferred. If the foot can not dorsiflex enough, the brace will not work/be tolerated. If it is determined the foot can not dorsiflex at least 10 degrees, the Achilles Tenotomy surgical procedure is ...
According to Lopate, et al., methylprednisolone is a viable treatment for chronic inflammatory demyelinative polyneuropathy (which can also be treated with intravenous immunoglobulin). The authors also indicate that prednisone has greater adverse effects in such treatment, as opposed to intermittent (high-doses) of the aforementioned medication.
Hereditary neuropathy with liability to pressure palsy (HNPP) is a peripheral neuropathy, a condition that affects the nerves. [4] Pressure on the nerves can cause tingling sensations, numbness , pain, weakness, muscle atrophy and even paralysis of the affected area.
Pes cavus can occur from four primary causes: neurological conditions, trauma, undertreated clubfoot, or idiopathic with other underlining conditions. [9]Bilateral presentation (i.e., in both feet) often occurs due to a hereditary or congenital source, whereas a unilateral presentation (i.e., in one foot) is often the result of trauma.