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By Dr. Kuvent, April 29, 2010 12:50 pm

          When you think of tumors you may think of cancer, and when you think of cancer, you probably don’t immediately think of the foot or ankle. However, there is in fact a very wide variety of tumors which do show up primarily in the foot and ankle. Thankfully, ten times as many of these lesions are benign as they are cancerous, but it’s still intriguing to note that 45% of soft tissue sarcomas occur in the lower extremity. One of the more common benign tumors of the foot is known as a “plantar fibroma”.

          Plantar fibromas are generally found in patients in their 20s, 30s, and 40s and are most commonly seen in men. About half of cases involve both feet, and they are more common in people with epilepsy, diabetes, and alcoholics with liver disease. Also, they are classically associated with a condition involving the hands in which the ring and small fingers are contracted forwards and are unable to be straitened. This is called a Dupuytren’s contracture. Of course, it’s important to remember that not all individuals with this condition fit these criteria.

          Essentially, plantar fibromas are thickenings of fibrous tissue within the plantar fascia which is a normal band of tissue that runs along the sole. These nodule-like thickenings are usually found towards the middle or inside of the sole, and they sometimes arise in non-weight-bearing areas making them asymptomatic. On the other hand, the lesions can grow to 2 cm in diameter, and although they are not cancerous, they can be locally aggressive leading to significant pain and discomfort when walking.

          A major key to properly managing plantar fibromas is achieving the correct diagnosis. This is because there are so many other possible tumors and lesions-both benign and malignant-within the foot and ankle. Your local Chandler podiatrist can help you in determining whether your condition is actually a ganglion cyst, an infection, hernias of the fat pad, tumors involving nervous tissue, a cancerous lesion, or indeed a plantar fibroma. In some cases, an MRI may be requested to help the doctor make this distinction.

          The treatment for plantar fibromas is based on the grade, size, and location of the tumors as well as the nature of your symptoms. Foot doctors like to start out as conservatively as possible by implementing certain medications, shoe-gear modifications, steroid injections, and other modalities before moving on to surgical intervention. In severe cases such as those involving pain, difficulty fitting into shoes, or a growing lesion, the doctor may recommend surgery to excise the lesion. There is a chance of recurrence, however.

          If you have symptoms of a plantar fibroma, such as painful ‘lumps’ on the soles of your feet, feel free to call and make an appointment today.

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By Dr. Kuvent, May 26, 2009 2:03 am

As you can imagine, human feet are incredibly complex and impressive structures. Just think of all the functions that your feet perform every day! Each human foot contains roughly 26 bones and 33 joints. That actually accounts for about a quarter of all the bones in the body! The coordinated movements that we often take for granted require efficient and effective motion between each of those bones and joints. Occasionally, however, some of the bones can develop unions or connections with other bones which can have a big impact on the function and comfort of your feet.

In most circumstances, the connections which reduce or stop motion between bones show up in the middle or hind part of the foot below the ankle. These unions are often bony themselves, but can also be made up of cartilage or fibrous tissue as well. They’re certainly nothing new. Doctors back in the 1700’s first began to describe this condition, and a pre-Colombian Indian skeleton from around 1000 AD even had one!

Unions between bones in the foot may be acquired over time or congenital- showing up in fetuses as early as the first trimester. Some acquired causes may include trauma, arthritis, or even tumors. Either way, they can present in a variety of ways. Patients may experience pain, muscle spasms, decreased motion, or no symptoms at all. Pain is usually localized to the outside top of the foot or the entire rear-foot, and often comes on after activity. Walking over rough surfaces is especially painful. Individuals-especially children-who develop a stiff flatfoot on one side but not the other have a very high chance of having a bony connection in that foot.

Podiatrists perform a number of simple clinical exams as well as radiographic techniques to quickly assess whether an individual has a bony union or not. They’re able to localize the issue and determine the extent of the problem, and of any arthritic changes. After that, a number of conservative measures may be implemented to address the problem. If these measures fail, surgery may be recommended to address the needs of that specific foot.

Physical activity is a critical part of everyone’s healthy lifestyle, and walking should not be painful. If your feet become rigid or uncomfortable, you should have them examined professionally. You’ll be glad you did!