A goitre is an enlargement of the thyroid gland ( Fig. 25 ). It can result from physiological causes such as puberty (due to increased demand for thyroid hormone) which require no treatment, to frank malignant disease requiring urgent diagnosis…
Disorders of gait may be structural or neurological. When assessing gait, it is important to observe the whole patient and not merely the feet. Causes Structural ● Pain – antalgic gait ● Length discrepancies – short leg gait ● Weak…
Ulcers on the feet are common. The majority of them are of vascular or neuropathic origin. Causes Vascular Large vessel disease ● Arteriosclerosis ● Embolism Small vessel disease ● Diabetes ● Raynaud’s disease ● Embolism ● Vasculitis, e.g. SLE, rheumatoid…
Pain in the foot is a common presenting complaint. The majority of causes are related to injury, overuse or conditions causing inflammation. Causes Traumatic ● Fractures ● March fracture Infective ● Cellulitis – esp if suspected necrotising fascitis ● Osteomyelitis…
The deformity will often be apparent at birth but occasionally does not present until the child starts walking. A deformity of the foot and ankle is normally referred to as ‘talipes’. Other terms may qualify the word talipes, e.g. varus…
A painful finger is a common presenting symptom. This may vary from an obvious local lesion to part of a generalised disease, e.g. rheumatoid arthritis. Impairment of the function of even a single finger may grossly impair the overall function…
Finger lesions form part of the wider subject of hand deformity. (See hand deformity chapter.) Lesions of the fingers are those which can result in hand function impairment. Painful finger lesions are dealt with on p. 147. Causes Congenital See…
Faecal incontinence implies loss of voluntary control of passage of faeces from the anus. Any disease process that interferes with rectal sensation or affects function of the anorectal musculature may produce incontinence. However, incontinence may still occur with normal sphincters…
Most facial ulcers are serious. Malignant facial ulcers are common in patients who work outdoors and are exposed to ultraviolet light. Lesions of the lips have been dealt with elsewhere (p. 293) and will not be included here. Causes Traumatic…
Facial swelling is a common presenting complaint. It may be generalised or localised. Many cases are due to trauma or infection, but it may be a sign of systemic disease. Causes Traumatic ● Insect bites ● Facial fractures Infective ●…