Foot and Ankle: Services
Evaluation and Diagnosis
Most diseases that affect the lower extremities require x-rays in combination with
routine clinical examination. At times, when further evaluation is warranted, a
computerized tomography (CT) scan is ordered. If additional soft tissue evaluation
is needed, a magnetic resonance imaging (MRI) test or ultrasound is ordered.
When a patient arrives at the clinic, they will be evaluated and their records reviewed
by a specialist. If adequate x-rays are available, they will be reviewed or a new
set ordered if additional views are felt to be necessary. Once a decision is made
regarding the appropriate course of treatment and a CT or MRI deemed necessary,
the patient will be given a return appointment once the CT and/or MRI has been performed.
Both are routine procedures that take a short period of time to complete.
On the return visit, the studies are reviewed with the patient and treatment recommendations
are discussed. In most cases, nonsurgical treatment can be started at a follow-up
visit within six to eight weeks. If surgery is required, the surgeon will discuss
the entire process with the patient.
The treatment for severe arthritis is nonsteroidal anti-inflammatory drugs (NSAIDS),
physical therapy, glucosamine chondroitin sulfate and possibly injection therapy.
If surgery is required, the standard procedures are joint replacement or fusion.
Fusion eliminates the painful joint and allows the bones to heal together using
internal hardware to hold the bone rigidly.
Treatment for bunions includes padding, shoe modification and splints. If surgery
is required, the bone is remodeled to correct the deformity. Some procedures require
metal hardware to ensure the remodeled bone remains in position until it is healed.
Toe deformity treatment consists of padding and shoe modification, as well as shaving
calluses, if any are present. When surgery is necessary, a small piece of the bone
is removed to correct and straighten the toe.
After each of these procedures, pain is usually greatest the first few days after
surgery. Your surgeon may prescribe pain medication or recommend an over-the-counter
pain reliever. You will need to stay home for three to seven days, even longer if
you are ordered not to put weight on your ankle or foot. Follow-up visits are usually
arranged at one to two weeks, then at four to six weeks and again at ten to 12 weeks.
Physical therapy is needed after some surgeries.