The foot and ankle are rare sites of involvement for giant cell tumor of tendon sheath. We present three rare cases of giant cell tumor of tendon sheath arising from the tendon sheaths of the flexor hallucis longus, peroneus brevis, and extensor hallucis brevis tendons, along with a literature review of such cases in the foot and ankle region. All of the patients were treated with surgical excision of the mass and were asymptomatic after minimum follow-up of 18 months. Giant cell tumor of tendon sheath involving the foot and ankle region is a rare clinical entity, and good results can be expected after surgical excision.
Locomotor diversity of Eocene primates of North America and Europe was well developed, with species of both Adapidae and Omomyidae showing a wide spectrum of movements. Besides documenting the locomotor diversity in the Eocene, this paper shows that adapid foot morphology shares derived features with extant strepsirhines. Thus, the Omomyidae best resemble the ancestral euprimate in terms of foot morphology and locomotion. The generalized locomotor repertoire of the modern cheirogaleids represents the best model for the movement pattern of the ancestral euprimate.
Diabetic neuropathy is the most prevalent chronic complication of diabetes mellitus (DM). Diabetic neuropathy most commonly presents as a distal sensorimotor neuropathy, where reduced or absent protective sensation in the lower limbs leads to an increased risk of foot ulcers and peripheral neuropathic pain is common. Diabetic neuropathy can also present as acute neuropathies, however, in this article we present three of the less common acute presentations of diabetic neuropathy and discuss appropriate investigations, treatment and prognosis. We also highlight an important and potentially underappreciated link between tightening of glycaemic control and acute diabetic neuropathies.
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Introduction: Foot thermograms depict vascular distribution among foot regions with a spectrum of thermal values. Infrared thermography (IRT) is used to explore challenges in diagnosing complications that involve temperature differences.
Problem Statement: It is crucial to identify underlying diabetic ulcers in the foot plantar regions, which are typically missed in photographic images. Early detection of ulcer onset can reduce healing time and treatment costs; thus, IRT plays a vital role in identifying early-stage ulcers by detecting vascular changes. This systematic review aimed to identify studies of thermography in foot ulcer diagnosis, including analysis techniques, extracted features, and scores among patients.
Method: A literature search was conducted in PubMed and Scopus databases to identify relevant articles published within the last 10 years. The main criteria for the search results were articles in English with abstracts, and full articles that examine the relationship between diabetes mellitus (DM), foot ulcer and thermography among DM patients.
Results: The search identified 2,215 articles, with only 8 studies meeting the inclusion criteria. Foot thermograms were used to identify foot ulcer regions associated with temperature differences. The studies included parameters such as ankle brachial index (ABI), toe brachial index (TBI), age, sex, duration of diabetes, and type of diabetes for statistical analyses to verify the validity of temperature difference data in asymmetrical analysis.
Conclusion: Further interventional studies should be conducted to investigate foot IRT in patients with DM, as a variation in temperature differences may challenge the validity of foot thermograms in foot ulcer grading.
Hence, this systematic review will focus on conditions associated with type 2 diabetes in the general population in India, in which the incidence rate is high. DM is a group of metabolic disorders that is characterized by high glucose levels in the blood. The regulation of blood glucose levels is essential to avoid the development of pathological conditions caused by either hyperglycemia or hypoglycemia. Hyperglycemia is a condition in which blood glucose levels are elevated, leading to a non-enzymatic glycation stage, which causes functional and structural disruptions to blood vessels. These anomalies affect major organs through micro and macrovascular complications which include peripheral neuropathies, poor wound healing or chronic neuropathy, coronary artery disease, cerebral vascular disease, and chronic kidney disease2. Among these, diabetic neuropathy is a major concern, in which the nerve fibers of the lower limbs of the body can become damaged by persistently high blood glucose levels4. Most diabetic foot ulcers are due to both ischemic and neuropathic conditions and are associated with pain and numbness in the extremities, as well as complications that include bacterial infection and deep-tissue destruction5, 6, 7. Figure 2 shows various complications that occur in the diabetic foot. This type of ulceration may lead to amputation of the foot due to chronic wounds that fail to heal6. Current practice for foot care in DM includes a complete history and physical examination, in addition to assessment by an expert and the time needed for a proper evaluation8, 9, 10, 11.
The main inclusion criteria for the search results were articles in English with abstracts, and full articles that discussed the relationship between DM, foot ulcer, and IRT among DM subjects. Studies that included animals or tissue cultures were excluded. In addition, review papers, letters, conference papers, articles in the press, editorials, and short surveys were excluded. For the present systematic review, only studies that showed the relationship between DM, foot ulcer, and IRT were selected. Articles were filtered in three stages before they were selected for inclusion in the review. In the first stage, any articles that did not meet the inclusion criteria were removed. In the second stage, filters were applied for the range of years between 2010 and 2020, and only full articles were screened. In the final stage, articles that contained the selection criteria keywords were included. All readers had to agree on the criteria of the selected articles to be reviewed before the data extraction stage. Any conflicts of opinion were resolved by rational discussion among the reviewers. All data searching was performed independently through data search engines. The following data were obtained from the articles and tabulated accordingly: year of publication, pre-processing type, segmentation technique, automated vs. manual region of extraction, and classifiers used. The search found twelve articles potentially related to the search criteria, of which eight articles met the inclusion criteria (Figure 3).
Extensive studies on the diabetic foot using thermography techniques for identifying and classifying the thermal variations in the plantar region have been carried out. The angiosomes were combined in a new classification matrix consisting of 20 types of thermal patterns27. The medial plantar artery (MPA) and lateral plantar artery (LPA) thermal patterns for 32 healthy subjects and 129 patients with diabetes without foot ulcers are represented in the rows, and the medial calcaneal artery (MCA) and lateral calcaneal artery (LCA) of the thermal patterns are represented in the columns. Statistical analysis revealed that temperature patterns differed significantly between healthy individuals and those with diabetes. Atypical patients were defined as those who did not fit into any of the 20 categories. This categorization scheme could be utilized in foot care and surgical interventions to identify vascular conditions.
The authors of another study32 proposed a method that employed image processing and morphological approaches to overcome the deformations produced by amputation. K means and EM clustering were used to distinguish between ambient and foot temperatures. Temperature differences were utilized as a significant factor in study33 to distinguish between DM patients, with and without complications. In comparison to patients with DM, without complications, PAD-affected DM patients showed temperatures greater than 26.2 C. In one study with 43 subjects34 the PAD from 21 regions of interest were characterized. Features were extracted and classified using the support vector machine (SVM) model.
A literature search was conducted to investigate the relationship between DM, foot ulcers, and classification of the ulcers using thermography in patients with DM. PubMed and Scopus databases were used to identify relevant articles published between 2010 and 2020. Related articles were identified by using two groups of keywords: (1) classification of foot ulcers using thermography AND (2) pre-processing techniques for the classification of foot ulcers OR image segmentation techniques for the classification of foot ulcers OR pre-processing techniques for the classification of foot ulcers. 59ce067264