Onychogryphosis

A gryphotic nail is one which is thickened and deformed. They are often referred to as a 'Ram's Horn'

Onychogryphosis  occurs as a result of damage to the nail either due to one major event, like dropping something heavy on the foot, or multiple minor events.  These minor events can be as varied as having a shoe with a tight toe box causing impaction on the  toes,  to repeated forward movement of the foot in footwear, for example a runner whose toes push to the end of a trainer causing impaction.  Keen walkers are also prone to onychogryphosis, especially hill walkers.

They are difficult to manage at home and usually need professional care from a podiatrist.  If they are not treated they can lead to ulcerations and infections. They can also be very uncomfortable.

Please don't be embarrassed , treatment is very simple and straightforward.

.

Chikungunya - The Treatment

 

Chikungunya is a mosquito transmitted virus which is becoming more widespread. It has recently been  reported in the Caribbean and France.  The symptoms usually appear within 3- 7 days of a bite.

To prevent the mosquito attack, use repellants on your skin at all times, wearing long sleeves and long trousers whenever possible. Keep mosquito nets over beds and the doors and windows screened. Better still, use air conditioning whenever it is available.

Don't allow water to stand in containers outside.

 The chikungunya rash

There is no medication available to treat the chikungunya virus.  

It is important to keep your fluid levels high to prevent dehydration and to take anti-inflammatories and pain relievers. Get plenty of rest.

If you suspect a mosquito bite from an area where the virus is present and the symptoms are present, it is essential to seek medical advice.

Some people benefit greatly from physiotherapy and podiatry who can offer therapies which are designed for the relief of  arthritis. Chikungunya sufferers may require orthotics for many months after the virus has passed.

After our lady sufferer had visited our surgery, she said of the Chikungunya Virus

"It has affected me so much that I will never go back to the Caribbean. Even though my son lives there."

Chikungunya - The Symptoms

Chikungunya is a mosquito transmitted virus which has evolved since the 1950's , becoming more widespread. It has recently been  reported in the Caribbean and France.  The symptoms usually appear within 3- 7 days of a bite which are high fever and disabling painful joints, most often in the hands and feet. People who have contracted chikungunya may also suffer with nausea, vomiting, headaches and a rash. Between 72 - 93% of infected people become symptomatic. Death is rare.

It is reported that acute symptoms last for around  one to two weeks, although some people suffer with painful joints for months or even years afterwards.

The symptoms are very similar to another disease called Dengue. 

Dengue is transmitted by the same mosquito as chikungunya,  and displays similar symptoms. 

Dengue is also a killer.

An incidence reported in France mainland recently occurred in two children aged 8 and 10 who had returned from a visit to  Martinique.  They both had acute fever and painful joints. The boy had swollen knees and they both had rashes on their bodies. 

The most vulnerable are the elderly and the very young and those with underlying medical conditions.

Complications due to an episode of the Chikungunya virus include painful eye conditions, retinitis and uveitis. Inflammation of the liver, kidney and the meninges of the brain.  Some patients have repeated relapses of rheumatologic symptoms after the acute phase has passed.

Chikungunya (What - on EARTH??)

A patient called her podiatrist for an appointment this week as she had been suffering with chikungunya and she needed some therapy on her joints.

Naturally some research was required (as this was something not encountered previously!)  and we thought you may like to share our findings. Interestingly, Chikungunya is caused by a mosquito type bite and is most common in hotter lands than the UK;  although there have been reported outbreaks as close as Northern Europe.  Not surprisingly, Chikungunya is on the increase.

 Countries with reported local transmission of chikungunya virus (as of July 2014)

Chikungunya  is a virus and is transmitted by aggressive biting mosquitoes, which attack during the day. Once infected , the person has a high fever and severely debilitating painful joints, very often in their hands and feet. Our lady suffered severe vomiting and was hospitalised for a number of days. She was weakened and the painful joints made it difficult for her to walk. The mosquito responsible in her case, was very large and she witnessed the bite.

Outbreaks have previously been reported in Africa, Asia, Indian and Pacific Oceans. Although the virus has been reported since the 1950's, the incidence has been mainly in developing countries and sadly little interest was shown. An outbreak in the French colony of La Reunion in the Indian Ocean during 2005 motivated France to invest in research.  The first transmission of the virus in the Caribbean, was reported in 2013. So be aware if you are travelling to this popular destination.

Chondromalacia - Diagnosis and Treatment

Chondromalacia patella is a painful condition of the knee caused by a breakdown of the cartilage behind the knee cap, usually caused by overuse or direct trauma.
If you think you may be suffering from chondromalacia patella, the first line of treatment is to rest, apply compression and ice to the area to reduce inflammation.

It is important to visit a professional to have the cause identified. A biomechanical assessment will identify any problems with your walking and the alignment of joints. For example a foot which is not aligned with the knee may be causing the lower leg to rotate, putting a twist on the knee. Any problems can be corrected and strengthening exercises can be prescribed.


Patella taping can be used to instantly reduce pain by preventing the kneecap from constantly rubbing.  A patella knee support can support the patella and relieve pain. In some cases manipulation techniques can ease the discomfort.

A full knee exercise regime should be undertaken.. Exercises aimed at increasing the strength of the muscle on the inside of the knee and stretching the muscle on the outside of the knee is most often needed, although your podiatrist or physiotherapist will advise accordingly.  

The main message is, don't suffer in silence.  Visit your podiatrist and request a biomechanical assessment. Help is out there!

Chondromalacia - What are the symptoms?

Chondromalacia patella is a breakdown of the cartilage in the knee, usually due to trauma or mal-tracking of the patella over the knee joint.

The most common symptom of chondromalacia patella,  is a dull, aching pain in the front of your knee, behind your kneecap/patella. It can flare up after you have been sitting in one position for a long time. For example, your knee may be painful and stiff after a long trip in a car or aeroplane and it is often worse first thing in the morning; it may therefore be confused with an arthritic problem.  The pain can get worse when you go up or down stairs.

Chondromalacia can sometimes make your knee joint "lock" which means you suddenly have trouble moving it past a certain point.  Sometimes the joint may buckle or not support you effectively, which tends to occur when you bend your knee repeatedly, especially when you go up or down stairs. Occasionally the knee may be swollen and hot. 




Chondromalacia can cause a grinding sensation when you move your knee. This is not always a true test of diagnosis, as there are many other conditions which cause the knee to creak.

If you are struggling with chondromalacia, please visit a professional for advice.

Chondromalacia - What is it?

You may have heard of Chondromalacia and know that it commonly refers to a condition of the knee. 
Why would the Footcare Clinic be interested in a knee problem?
Actually, any problem which causes you to walk differently is of paramount importance to your podiatrist because it will be affecting your feet and the problems you may have. Conversely, the way you walk and the angle at which you position your foot during walking may be the cause of chondromalacia in the first place.

The joints in our bodies are cushioned with articular cartilage. As each joint moves, the cartilage helps to cushion the bones and allows them to glide smoothly over one another.

Sometimes, the cartilage inside a joint softens and breaks down. This condition is called chondromalacia. and  as the joint moves, the ends of the bones can rub together, causing pain. Sometimes the cartilage can wear away completely, exposing the bone underneath and then the surface can grind painfully against the other bone(s) in the joint. The cells in the area respond by producing fluid in the joint, called joint effusion, i.e. swelling.


In the knee, chondromalacia-patella can be caused by an acute injury such as sudden impact, or from overuse usually due to the position of the patella itself, known as mal-tracking, where the patella moves sideways as a result of a muscle imbalance.
It is common in young athletes who depend on knee activity, especially runners, skiers, cyclists and other athletes. Anyone who spends a lot of time kneeling is also at risk, for example, floor layers.

If you are suffering with knee pain, get it checked out and remember to mention it when you visit your podiatrist. They may be able to help with a biomechanical assessment and orthotics.