What Is The Bump On Side Of My Foot?

Tailor's bunion, also called a bunionette, is a prominence of the fifth metatarsal bone at the base of the little toe. The metatarsals are the five long bones of the foot. The prominence that characterizes a tailor's bunion occurs at the metatarsal "head", located at the far end of the bone, where it meets the toe. Tailor's bunions are not as common as bunions, which occur on the inside of the foot, but they are similar in symptoms and causes.
Why is it called a tailor's bunion? The deformity received its name centuries ago, when tailors sat cross-legged all day with the outside edge of their feet rubbing on the ground. This constant rubbing led to a painful bump at the base of the little toe.
Often a tailor's bunion is caused by an inherited faulty mechanical structure of the foot. In these cases, changes occur in the foot's bony framework, resulting in the development of an enlargement. The fifth metatarsal bone starts to protrude outward, while the little toe moves inward. This shift creates a bump on the outside of the foot that becomes irritated whenever a shoe presses against it.

Sometimes a tailor's bunion is actually a bony spur (an outgrowth of bone) on the side of the fifth metatarsal head.
Regardless of the cause, the symptoms of a tailor's bunion are usually aggravated by wearing shoes that are too narrow in the toe, producing constant rubbing and pressure.
The symptoms of tailor's bunion include redness, swelling, and pain at the site of the enlargement. These symptoms occur when wearing shoes that rub against the enlargement, irritating the soft tissues underneath the skin and producing inflammation.
Tailor's bunion is easily diagnosed because the protrusion is visually apparent. X-rays may be ordered to help the foot and ankle surgeon determine the cause and extent of the deformity.
Treatment for tailor's bunion typically begins with non-surgical therapies. Your foot and ankle surgeon may select one or more of the following:
*Shoe modification. Choose shoes that have a wide toe box, and avoid those with pointed toes or high heels.
*Padding. Bunionette pads placed over the area may help reduce pain.
*Oral Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help relieve the pain and inflammation.
*Icing. An ice pack may be applied to reduce pain and inflammation. Wrap the pack in a thin towel rather than placing ice directly on your skin.
*Injection Therapy. Injections of corticosteroid may be used to treat the inflamed tissue around the joint.
*Orthotic Devices. In some cases, custom orthotic devices may be provided by the foot and ankle surgeon.
Surgery is often considered when pain continues despite the above approaches. In selecting the procedure or combination of procedures for your case, the foot and ankle surgeon will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of recovery period will vary, depending on the procedure of procedures performed.
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Why Does My Child Have A Flat Foot?

Flatfoot is common in both children and adults. When this deformity occurs in children, it is referred to as

"pediatric flatfoot". Although there are various forms of flatfoot, they all share one characteristic- partial or total collapse of the arch. 
Pediatric flatfoot can be classified as symptomatic or asymptomatic. Symptomatic flatfeet exhibit symptoms such as pain and limitation of activity, while asymptomatic flatfeet show no symptoms. These classifications can assist your foot and ankle surgeon in determining an appropriate treatment plan.
Flatfoot can be apparent at birth or it may not show up until years later. Most children with flatfoot have no symptoms, but some have one or more of the following symptoms:

• Pain, tenderness, or cramping in the foot, leg, and knee
• Outward tilting of the heel
• Awkwardness or changes in walking
• Difficulty with shoes
• Reduced energy when participating in physical activities
• Voluntary withdrawal from physical activities

In diagnosing flatfoot, the foot and ankle surgeon examines the foot and observes how it looks when the child stands and sits. The surgeon also observes how the child walks and evaluates the range of motion of the foot. Because flatfoot is sometimes related to problems in the leg, the surgeon may also examine the knee and hip.
X-rays are often taken to determine the severity of the deformity. Sometimes additional imaging and other tests are ordered.
If a child has no symptoms, treatment is often not required. Instead the condition will be observed and re-evaluated periodically by the foot and ankle surgeon. Custom orthotic devices may be considered for some cases of asymptomatic flatfoot.
When the child has symptoms, treatment is required. The foot and ankle surgeon may select one or more of the following non-surgical approaches:

• Activity modifications. The child needs to temporarily decrease activities that bring pain as well as avoid prolonged walking or standing.
• Orthotic devices. The foot and ankle surgeon can provide custom orthotic devices that fit inside the shoe to support the structure of the foot and improve function.
• Physical therapy. Stretching exercises, supervised by the foot and ankle surgeon or a physical therapist, provide relief in some cases of flatfoot.
• Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to help reduce pain and inflammation.
• Shoe modification. The foot and ankle surgeon will advise you on footwear characteristics that are important for the child with flatfoot.

In some cases, surgery is necessary to relieve the symptoms and improve foot function. The surgical procedure or combination of procedures selected for your child will depend on his or her type of flatfoot and degree of deformity.
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What Is That Extra Bone In My Foot?

The accessory navicular (os navicularum or os tibiale externum) is an extra bone or piece of cartilage located on the inner side of the foot just above the arch. It is incorporated within the posterior tibial tendon, which attaches in this area.
An accessory navicular is congenital (present at birth). It is not part of normal bone structure and therefore is not present in most people.

People who have an accessory navicular often are unaware of the condition if it causes no problems. However, some people with this extra bone develop a painful condition known as accessory navicular syndrome when the bone and/or posterior tibial tendon are aggravated. This can result from any of the following:

• Trauma, as in a foot or ankle sprain
• Chronic irritation from shoes or other footwear rubbing against the extra bone
• Excessive activity or overuse

Many people with accessory navicular syndrome also have flat feet (fallen arches). Having a flat foot puts more strain on the posterior tibial tendon, which can produce inflammation or irritation of the accessory navicular.
Adolescence is a common time for the symptoms to first appear. This is a time when bones are maturing and cartilage is developing into bone. Sometimes, however, the symptoms do not occur until adulthood. The signs and symptoms of accessory navicular syndrome include:

• A visible bony prominence on the midfoot (the inner side of the foot, just above the arch)
• Redness and swelling of the bony prominence
• Vague pain or throbbing in the midfoot and arch, usually occurring during or after periods of activity

To diagnose accessory navicular syndrome, the foot and ankle surgeon will ask about symptoms and examine the foot, looking for skin irritation or swelling. The doctor may press on the bony prominence to assess the area for discomfort. Foot structure, muscle strength, joint motion, and the way the patient walks may also be evaluated.
X-rays are usually ordered to confirm the diagnosis. If there is ongoing pain or inflammation, an MRI or other advanced imaging tests may be used to further evaluation the condition.
The goal of non-surgical treatment for accessory navicular syndrome is to relieve the symptoms. The following may be used:

• Immobilization. Placing the foot in a cast or removable walking boot allows the affected area to rest and decreases the inflammation.
• Ice. To reduce swelling, a bag of ice covered with a thin towel is applied to the affected area. Do not put ice directly on the skin.
• Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, may be prescribed. In some cases, oral or injected steroid medications may be used in combination with immobilization to reduce pain and inflammation. 
• Physical therapy. Physical therapy may be prescribed, including exercises and treatments to strengthen the muscles and decrease inflammation. The exercises may also help prevent recurrence of the symptoms.
• Orthotic devices. Custom orthotic devices that fit into the shoe provide support for the arch, and may play a role in preventing future symptoms. 

Even after successful treatment, the symptoms of accessory navicular syndrome sometimes reappear. When this happens, non-surgical approaches are usually repeated.
If non-surgical treatment fails to relieve the symptoms of accessory navicular syndrome, surgery may be appropriate. Surgery may involve removing the accessory bone, reshaping the area, and repairing the posterior tibial tendon to improve its function. This extra bone is not needed for normal foot function.

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Is 49ers Crabtree's Season Done Already?

When injuries like these happen, you know it's going to take a long time for someone to recover. 

San Francisco 49ers wide receiver Michael Crabtree tore his Achilles tendon during organized team activities on Tuesday.
According to NFL.com's Ian Rapoport Crabtree has already had surgery to repair the tendon and will begin six months of rehabilitation. Crabtree could return as early as November.
49ers coach Jim Harbaugh talked with reporters on Wednesday and confirmed that the wide receiver had successful surgery. He does not expect Crabtree to miss the whole season. 
In days past, an injury like this meant the player would be out the entire season, but due to advances in podiatric medicine, recovery from surgery is greatly reduced. Last spring Baltimore Ravens linebacker Terrell Suggs and Tampa Bay Buccaneers defensive end Da'Quan Bowers tore their Achilles tendons and rejoined their teams after time recuperating. However, neither player was 100 percent when they returned to the field. 
Denver Broncos wide receiver Demaryius Thomas tore his tendon during training in February 2011, right after his rookie season. Thomas had surgery and was cleared to practice seven months later, after missing all of the Broncos' offseason workouts and training camp. He wasn't fully back until October 2011 and can sympathize with how Crabtree is feeling.
"He's a great player and I'm sure he's going to work hard to get back and listen to all the people that he's got to listen to," Thomas said. "But it's difficult at first, because it took a while for me to be able to do anything. You know, I had to wear a boot for six to eight weeks, and I couldn't do anything but upper body stuff. Once I got it off, I still had time, because it's a serious injury, and you don't want to take it too fast."
Crabtree, 25, had a stellar year for the 49ers last season. He had career highs in reception (85), yards (1,105), and touchdowns (9). In the three seasons past Crabtree had struggled to live up to the expectations the team put on him after drafting him 10th overall in 2009.
Crabtree had a great postseason as well, with 20 catches for 285 yards and three touchdowns, with one touchdown in the Super Bowl. He had the potential to score the winning goal when he was the intended target on a quick rollout pass on third-and-goal and a fade on fourth-and-goal that went over his head as he was defended by Ravens cornerback Jimmy Smith. Harbaugh wanted a pass-interference call on both plays but was denied by referees. 
Reference: USA Today.
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My Ankle Hurts When I Point My Toes!

The os trigonum is an extra (accessory) bone that sometimes develops behind the ankle bone (talus). It is connected to the talus by a fibrous band. The presence of an os trigonum in one or both feet is congenital (present at birth). It becomes evident during adolescence when one area of the talus does not fuse with the rest of the bone, creating a small extra bone. Only a small number of people have this extra bone.
Often, people don't know they have an os trigonum if it hasn't caused any problems. However, some people with this extra bone develop a painful condition known as os trigonum syndrome.

Os trigonum syndrome is usually triggered by an injury, such as an ankle sprain. The syndrome is also frequently caused by repeated downward pointing of the toes, which is common among ballet dancers, soccer players, and other athletes.
For the person who has an os trigonum, pointing the toes downward can result in a "nutcracker injury". Like an almond in a nutcracker, the os trigonum is crunched between the ankle and heel bones. As the os trigonum pulls loose, the tissue connecting it to the talus is stretched or torn and the area becomes inflamed.
The signs and symptoms of os trigonum syndrome may include:

• Deep, aching pain in the back of the ankle, occurring mostly when pushing off on the big toe (as in walking) or when pointing the toes downward
• Tenderness in the area when touched
• Swelling in the back of the ankle

Os trigonum syndrome can mimic other conditions such as Achilles tendon injury, ankle sprain, or talus fracture. Diagnosis of os trigonum syndrome begins with questions from the doctor about the development of the symptoms. After the foot and ankle are examined, x-rays or other imaging tests are often ordered to assist in making the diagnosis.
Relief of symptoms is often achieved through treatments that can include a combination of the following:

• Rest. It is important to stay off the injured foot to let the inflammation subside.
• Immobilization. Often a walking boot is used to restrict ankle motion and allow the injured tissue to heal.
• Ice. Swelling is decreased by applying a bag of ice covered with a thin towel to the affected area. Do not put ice directly against the skin. 
• Oral medication. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation.
• Injections. Sometimes cortisone is injected into the area to reduce the inflammation and pain. 

Most patients' symptoms improve with non-surgical treatment. However, in some patients, surgery may be required to relieve the symptoms. Surgery typically involves removal of the os trigonum, as this extra bone is not necessary for normal foot function.
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What Is The Bump On the Back Of My Heel?

Haglund's Deformity, also known as "pump bump" or "retrocalcaneal bursitis" is a painful enlargement of the

back of the heel bone that becomes irritated by shoes. 
It normally appears as a red, painful, swollen area in the back of the heel bone. Women tend to develop the condition more than men because of irritation from rigid heel counters of shoes rubbing up and down on the back of the heel bone.
Haglund's Deformity presents as a red, painful, and swollen area in the back of the heel bone (calcaneus). Patients may also develop pain upon motion of the ankle joint and after activity due to irritation of the Achilles tendon. The syndrome usually occurs in females in the 2nd to 3rd decade, due to the irritation of the rigid heel counter of the shoe rubbing up and down on the back of the heel bone.
A podiatric physician will attempt one of a few simple therapies. In the mild cases, padding of the area may be indicated. Your doctor may recommend alternative shoe styles, including open back shoes. Oral anti-inflammatory medications and cortisone injections may also help diminish the acute inflammation of the heel. Orthotics or arch supports may also be fabricated to prevent recurring symptoms. If conservative therapy fails, surgery will be utilized to correct this painful condition. Surgery consists of removal of the excess bone.
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What Is A High-Arched Foot?

Cavus foot, or high-arched foot, is a condition in which the foot has a very high arch. Because of this high arch, an excessive amount of weight is placed on the ball and heel of the foot when walking or standing. Cavus foot can lead to a variety of signs and symptoms, such as pain and instability. It can develop at any age, and can occur in one or both feet.
Cavus foot is often caused by a neurologic disorder or other medical condition such as cerebral palsy, Charcot-Marie-Tooth disease, spina bifida, polio, muscular dystrophy, or stroke. In other cases of cavus foot, the high arch may represent an inherited structural abnormality.

An accurate diagnosis is important because the underlying cause of cavus foot largely determines its future course. If the high arch is due to a neurologic disorder or other medical condition it is likely to progressively worsen. On the other hand, cases of cavus foot that do not result from neurologic disorders usually do not change in appearance.
The arch of a cavus foot will appear high even when standing. In addition, one or more of the following symptoms may be present:

• Hammertoes (bent toes) or claw toes (toes clenched like a fist).
• Calluses on the ball, side, or heel of the foot.
• Pain when standing or walking.
• An unstable foot due to the heel tilting inward, which can lead to ankle sprains.

Some people with cavus foot may also experience foot drop, a weakness of the muscles in the foot and ankle that results in dragging the foot when taking a step. Foot drop is usually a sign of an underlying neurologic condition.
Diagnosis of cavus foot includes a review of the patient's family history. The foot and ankle surgeon examines the foot, looking for a high arch and possible calluses, hammertoes, and claw toes. The foot is tested for muscle strength, and the patient's walking pattern and coordination are observed. If a neurologic condition appears to be present, the entire limb may be examined. The surgeon may also study the patterns of wear on the patient's shoes.
X-rays are sometimes ordered to further assess the condition. In addition, the surgeon may refer the patient to a neurologist for a complete neurologic evaluation.
Non-surgical treatment of cavus foot may include one or more of the following options:

• Orthotic devices. Custom orthotic devices that fit into the shoe can be beneficial because they provide stability and cushioning to the foot.
• Shoe modifications. High topped shoes support the ankle, and shoes with heels a little wider on the bottom add stability.
• Bracing. The surgeon may recommend a brace to help keep the foot and ankle stable. Bracing is also useful in managing foot drop. 

If non-surgical treatment fails to adequately relieve pain and improve stability, surgery may be needed to decrease pain, increase stability, and compensate for weakness in the foot.
The surgeon will choose the best surgical procedure or combination of procedures based on the patient's individual case. In some cases where an underlying neurologic problem exists, surgery may be needed again in the future due to the progression of the disorder.
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Why Do My Toes Curl?

Hammertoe is a contracture (bending) of one or both joints of the second, third, fourth, or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop.
Hammertoes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammertoes are flexible and the symptoms can often be managed with noninvasive measures. But if left untreated, hammertoes can become more rigid and will not respond to non-surgical treatment.

Because of the progressive nature of hammertoes, they should receive early attention. Hammertoes never get better without some kind of intervention.
The most common cause of hammertoes is a muscle/tendon imbalance. This imbalance, which leads to a bends of the toe, results from mechanical (structural) changes in the foot that occur over time in some people.
Hammertoes may be aggravated by shoes that don't fit properly. A hammertoe may result is a toe is too long and forced into a cramped position when a tight shoe is worn.
Occasionally, hammertoes are the result of an earlier trauma to the toe. In some people, hammertoes are inherited.
Common symptoms of hammertoes include:

• Pain or irritation of the affected toe when wearing shoes.
• Corns and calluses (a buildup of skin) on the toe, between two toes, or on the ball of the foot. Corns are caused by constant friction against the shoe. They may be soft or hard, depending upon their location.
• Inflammation, redness, or a burning sensation.
• Contracture of the toe.
• In more severe cases of hammertoe, open sores may form.

Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the degree of the deformities and assess any changes that may have occurred.
Hammertoes are progressive- they don't go away by themselves and usually they will get worse over time. However, not all cases are alike- some hammertoes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.
There is a variety of treatment options for hammertoe. The treatment your foot and ankle surgeon selects will depend upon the severity of your hammertoe and other factors.
A number of non-surgical measures can be undertaken:

• Padding corns and calluses. Your foot and ankle surgeon can provide or prescribe pads designed to shield corns from irritation. If you want to try over the counter pads, avoid the medicated types. Medicated pads are generally not recommended because they may contain a small amount of acid that can be harmful. Consult your surgeon about this option.
• Changes in shoewear. Avoid shoes with pointed toes, shoes that are too short, or shoes with high heels- conditions that can force your toe against the front of the shoe. Instead, choose comfortable shoes with a deep, roomy toe box and heels no higher than two inches.
• Orthotic devices. A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance. 
• Injection therapy. Corticosteroid injections are sometimes used to ease pain and inflammation caused by hammertoes.
• Medications. Oral nonsteriodal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
• Splinting/strapping. Splints or small straps may be applied by the surgeon to realign the bent toe. 

In some cases, usually when the hammertoe has become more rigid and painful, or when an open sore has developed, surgery is needed.
Often patients with hammertoe have bunions or other foot deformities corrected at the same time. In selecting the procedure or combination or procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity, the number of toes involved, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.
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What Is This Bump On My Big Toe?

A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe 

(metatarsophalangeal joint). Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes, sometimes overlapping a third toe (known as Hallux Valgus). The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallus Abducto Valgus. Bunions can also lead to other toe deformities, such as hammertoe. 

Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult- all contributing to chronic pain. Wearing shoes that are too tight is the leading cause of bunions. Bunions are not hereditary, but they do tend to run in families, usually because of a faulty foot structure. Foot injuries, neuromuscular problems, flat feet, and pronated feet can contribute to their formation. It is estimated that bunions occur in 33 percent of the population in Western countries. 

Treatment for Bunions

Because they are bone deformities, bunions do not resolve by themselves. The goal for bunion treatment is twofold: first, to relieve the pressure and pain caused by irritations, and second, to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include:

• The use of protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems. 
• Removal of corns and calluses on the foot.
• Changing to carefully-fitted footwear designed to accommodate the bunion and not contribute toward its growth. 
• Orthotic devices- both over-the-counter and custom made- to help stabilize the joint and place the foot in the correct position for walking and standing. 
• Exercises to maintain joint mobility and prevent stiffness or arthritis. 
• Splints for nighttime wear to help the toes and joint align properly. This is often recommended for adolescents with bunions, because their bone development may still be adaptable. 

Surgical Treatment

Depending on the size of the enlargement, misalignment of the toe, and pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunions. In these cases, bunion surgery, known as a bunionectomy, may be advised to remove the bunion and realign the toe. 
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Osteomyelitis of the Foot

Osteomyelitis is a type of bacterial bone infection that moves from acute to chronic phases quickly. The

infection usually begins in another part of the body and spreads to the bone via blood. Traumatic injury, frequent medication injections, diabetic ulcers on the foot, the use of a prosthetic device, and some surgical procedures can increase susceptibility to the underlying infection.
With osteomyelitis, the infected bone fill with a pus that deprives the bone of its needed blood supply. Over time, this can result in the death of bone tissue. It is caused by staphylococcus bacteria, a germ that can be found on healthy people. This bacteria can enter your bloodstream through pneumonia or a urinary tract infection and to the weakened bone. Staphylococcus bacteria can also be transmitted through other infections or wounds in your body and direct contamination via a compound fracture.
Those with osteomyelitis may find that they are experiencing chills and fever, pain in the area of the infection, and swelling, warmth, and redness over the affected area. Sometimes osteomyelitis has no signs or symptoms or has signs or symptoms that can easily be diagnosed as something else.
If you've recently had a compound bone fracture, deep puncture wound, or surgery to repair broken bones, you are at risk for osteomyelitis. Those with poorly controlled diabetes, peripheral arterial disease, and sickle cell disease impair good blood flow, and therefore your body has a difficult time fighting infections like osteomyelitis. Individuals who use medical tubing for dialysis machines, urinary catheters, or for long-term intravenuous tubing have an "open gateway" for germs to enter. Conditions and factors that impair the immune system, like chemotherapy, having an organ transplant, or needing to take corticosteroids also put you at risk. Finally, those who take illegal drugs through needles are at risk because the needles are not typically sterilized before use.
Complications from osteomyelitis may include:

• Bone death. Infection in the bone will impede blood circulation to the bone, and cause bone death. Your bone can, however, heal after surgery to remove small sections of dead bone. But, if a large part of your bone has died, amputation may be necessary. 
• Septic arthritis. Infection in bones can spread to nearby joints. 
• Impaired growth. In children with osteomyelitis, the growth plates are commonly affected. Normal growth can be affected in these areas.
• Skin cancer. In cases where osteomyelitis has turned pussy, the surrounding skin can develop squamous skin cancer. 

The presence of bone infection can be diagnosed with tests, such as bone scans, blood tests, X-rays, CT scans, MRIs, and bone biopsies.
Osteomyelitis infections are very difficult to cure with oral or intravenuous antibiotics. In chronic cases, surgical removal of the dead bone tissue is usually required. Antibiotics are typically given through a vein in your arm for four to six weeks. Side effects include nausea, vomiting and diarrhea. Surgery may include one of the following methods:

• Drain the infected area. By opening the area around the infection, your podiatric surgeon can drain any pus or fluid that has accumulated.
• Remove the diseased bone and tissue. The surgeon will debride, or remove, as much of the diseased bone and tissue as possible, taking a small portion of healthy bone to ensure the infection is gone.
• Restore the blood flow. Your surgeon may fill in the empty space from the debridement with a piece of bone or tissue as a temporary filler until you are healthy enough to get a bone or tissue graft. 
• Remove foreign objects. If you've had this procedure previously, old plates or screws may have to be removed. 
• Amputate the limb. This is a final recourse and will not happen in all cases. 

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Xanthomas of the Achilles Tendon

Xanthomas are skin lesions caused by fat accumulation of fat in the microphage immune cells in the skin.

They are indicative of lipid metabolism disorders, like high cholesterol levels, high blood fats, coronary artery heart disease, pancreatitis, and hyperlipidaemia.
There are several different types of xanthomas that can appear on the body, and one of the most common areas is on the Achilles tendon.
On the Achilles tendon they will appear slowly, and emerge as nodules on the tendon or ligament. This particular type of xanthoma is associated with severe hypercholesterolaemia and elevated LDL levels.
Most doctors will order blood and urine tests and X-rays to determine the cause of the elevated LDL levels and high cholesterol. It is crucial to determine the cause of the condition to lower the risk for further complications, which can include heart attacks, stroke, and peripheral vascular disease.
Treatment for xanthomas includes identifying and treating the underlying lipid disorder. In many cases, treating the disorder will reduce and sometimes eliminate the xanthoma. Dietary measures will be recommended, and may include:

• Preparing meals from vegeatables, fish, and cereals.
• Minimize intake of saturated fats (meats, dairy products, oils).
• Minimize intake of simple, refined sugars (sodas, sweets).
• Lose weight if overweight or obese.

Medications prescribed may include:

• Statins, like simvastatin and atorvastatin, which reduce cholesterol production in the liver.
• Fibrates, like bezafibrate, which can reduce the triglyceride production by the liver and increase HDL (good cholesterol).
• Ezetimibe, which is given to the most severe patients. This medication will reduce cholesterol absorption in the stomach.
• Nictinic acids lower cholesterol, LDL cholesterol, and increase HDL cholesterol.

Surgery may be recommended when the xanthomas do not resolve with appropriate treatment.

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Kaposi's Sarcoma

Before the AIDS epidemic Kaposi's sarcoma was mostly seen in elderly Italian and Jewish men. This

cancerous tumor of the connective tissue would take a long time to develop. In those with AIDS, Kaposi's sarcoma will progress quickly and may affect the lungs, skin, gastrointestinal tract, and other organs.

For those with AIDS, Kaposi's sarcoma is caused by a weakened immune system, HIV, and the human herpesvirus-8 (HHV-8). Those who have organ or kidney transplants are at risk for this disease as well. Along the equator, African Kaposi's sarcoma is common among young males. A different form is often seen in young African children.

The tumors will present as bluish-red or purple pumps on the skin. They are reddish-purple because they are rich in blood vessels. The lesions will often first appear on the feet or ankles, and later the thighs, arms, hands, face, or any other part of the body. Symptoms include shortness of breath and bloody sputum.

Your doctor will perform a series of tests to determine if you have Kaposi's sarcoma, including a bronchoscopy, CT scan, endoscopy, and skin biopsy. They will treat the condition depending on how much the immune system is suppressed, the number and location of the tumors, and your symptoms. Options include antiviral therapy against HIV, combination chemotherapy, freezing, and radiation therapy.

Complications from treatment may include coughing and shortness of breath if the condition has reached the lungs and leg swelling that is painful or causes infections if the disease is in the lymph nodes of the leg.

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