Sunday, January 9, 2011
Saturday, January 8, 2011
Pointed Nose Ultrasound
apprentice Metatarsal Formula
metatarsal formula can be analyzed by passive metatarsophalangeal extension and observe the height of the metatarsals. Any assessment of a metatarsal collapse indicates an increase of pressure at that point. The higher pressure zones often coincide with the hardness of the skin (helomas).
length of the metatarsals. metatarsal morphology responds to the need to cushion and spread the load. In the stance phase of gait, the contact starts at the heel and advances at the outer edge to the head of the 5 th goal, and hence, goal for goal until the head of 1 metatarsano, which performs the takeoff momentum of 1 finger.
The metatarsalgias represent a high percentage of the conditions of the forefoot and sole. A large number of them are considered as mechanical metatarsalgia by overloading. Metatarsal overload is given by the morphology metatarsal and heel shoes:
height metatarsal. The internal arch determines the alignment of the metatarsals. The metatarsal arch is reduced with the extension of the fingers. Walking in the boost phase, we conducted a metatarsophalangeal extension of 60 º. When we did the extension of fingers, the 5 metatarsal should be in line for an equitable burden sharing.
metatarsal formula can be analyzed by passive metatarsophalangeal extension and observe the height of the metatarsals. Any assessment of a metatarsal collapse indicates an increase of pressure at that point. The higher pressure zones often coincide with the hardness of the skin (helomas). length of the metatarsals. metatarsal morphology responds to the need to cushion and spread the load. In the stance phase of gait, the contact starts at the heel and advances at the outer edge to the head of the 5 th goal, and hence, goal for goal until the head of 1 metatarsano, which performs the takeoff momentum of 1 finger.
metatarsal length places the head of each metatarsal at a height. Metatarsal heads describe an increasingly harmonious curve from 5 º to 2 º goal.
On 1 metatarsal should be slightly shorter than the 2 nd. Fick angle is 30 degrees. Foot on the opening angle of 30 ° located at 1 st and 2 nd metatarsal at the same height, for takeoff.
We can analyze the formula of the metatarsal length meatarsofalángica performing passive flexion, so that the head.
Imagine that they had to move a heavy container. What would be the best way? Without doubt, lift one side and rolling it by its circumferential edge. Imagine now that the drum had been struck and was dented. When you roll it over the edge and get to the dented area, the drum would fall precipitously increasing the impact at that point. That's what happens when one of the metatarsal is longer.
We can analyze the formula of the metatarsal length meatarsofalángica performing passive flexion, so that the head.
Imagine that they had to move a heavy container. What would be the best way? Without doubt, lift one side and rolling it by its circumferential edge. Imagine now that the drum had been struck and was dented. When you roll it over the edge and get to the dented area, the drum would fall precipitously increasing the impact at that point. That's what happens when one of the metatarsal is longer.
A long metatarsal itself is overloaded
A short metatarsal overload neighbors
Viladot, in 1989, established a classification based on the length of the metatarsals, in what he called Metatarsal Formula:
Index minus, when on 1 goal is shorter than the 2 and then the rest are in gradual decline. This is the most frequent (56%).
Index plus-minus, when 1 º and 2 º are equal and greater than 3, 4 and 5, falling. Observed in 28% of the population.
Index plus, when the 1 st metatarsal is larger than 2 and this more than 3 º. Occurs with a frequency of 16% of the population.
Regardless of the morphology of the metatarsals, footwear is a constraint on the amount of pressure to get the forefoot. Under normal conditions, with flat shoes, the forefoot will receive less than half the weight. The higher the heel, the greater the percentage of body weight. A woman with 70 kg which were fit with 10 cm heels will receive 100% of their body weight on the forefoot. Now suppose that this woman has a collapse of the 2nd metatarsal. That means that the head of that goal is enduring, only static, 70 kg of pressure.
With age, fat pad that protects the metatarsal heads, they lose water and collagen becoming thinner, making it increasingly difficult to use heels.
Monday, January 3, 2011
Ms Saga Action Replay
interim criteria
The new preliminary criteria could be divided into two parts. The first part is the Widespread Pain Index or Index widespread pain (WPI). who no longer speaks of muscle tender points, but merely refers to areas: the shoulder girdle, arm, buttock, leg ... and has a value or 19 depending on the number of zones has been selected . Each area is selected if the patient has experienced pain in the past week. The WPI is the part that more weight in the criteria, but now also takes into account the cognitive disorders, fatigue, sleep disturbance and other symptoms.
The second is the SS Index Score or severity of symptoms, which could subdivided into two parts. The SS Score 1 takes into account the three most important after the pain: sleep, fatigue and attention disorders, memory and lightheadedness (here, the mood, despite being statistically significant and present, decided not to include) . This value can range between 0 and 9, being between o and 3 each of the 3 symptoms.
Everyone knows this picture. Is the map of the 18 points of fibromyalgia pain. These are the diagnostic criteria were established in 1990 by the American College of Rheumatology (ACR). You know: if they have at least 11 of 18 and are present in all four quadrants: top, bottom, left and right, and carries more than 3 months with pain, since it is already, fibromyalgia singing.
1990 These criteria were established after a study conducted by Frederick Wolfe and colleagues with 558 patients: 293 with fibromyalgia and 265 for the control group
The choice of these points has been widely criticized. Those 18 points, well may have been others, and could have been 23 instead of 18. Nor is it true that the target structure in fibromyalgia was the muscle. It is not the predominant muscle pain is pain, period. Therefore, the diagnostic criteria of 1990, were becoming obsolete as it advanced the knowledge about the disease. In fact, it was initially created to reaizar clinical trials, rather than diagnostic criteria.
Over the years, have appeared various diagnostic criteria, as an alternative to the ACR, but none has come to set.
In May 2010, the same American College of Rheumatology published a new preliminary criteria for the diagnosis of fibromyalgia. 20 years later, Wolfe and colleagues conducted a study of 829 patients previously diagnosed with fibromyalgia.
The new preliminary criteria could be divided into two parts. The first part is the Widespread Pain Index or Index widespread pain (WPI). who no longer speaks of muscle tender points, but merely refers to areas: the shoulder girdle, arm, buttock, leg ... and has a value or 19 depending on the number of zones has been selected . Each area is selected if the patient has experienced pain in the past week. The WPI is the part that more weight in the criteria, but now also takes into account the cognitive disorders, fatigue, sleep disturbance and other symptoms. 
The second is the SS Index Score or severity of symptoms, which could subdivided into two parts. The SS Score 1 takes into account the three most important after the pain: sleep, fatigue and attention disorders, memory and lightheadedness (here, the mood, despite being statistically significant and present, decided not to include) . This value can range between 0 and 9, being between o and 3 each of the 3 symptoms. 
segunsa The index of the severity of symptoms (SS Score 2) is a miscellany of symptoms: headache, itching, cramps, irritable bowel ... A list of 40 symptoms that have been in the last week, where:
if you have symptoms score 0 to 0.
between 1 and 10 the score at 1.
between 11 and 24 the score is 2.
and over 25 is a 3,
therefore the value range between 0 and 3. This is the part that has less weight in the criteria, and established according to the symptoms manifested by patients in the study of Wolfe.
They join the 1 st and 2 nd index of the severity of symptoms (SS1 + SS2) and that value will range between 0 and 12.
fibromyalgia is considered if there is widespread pain index (WPI) is of at least 7 and symptom severity index reaches 5 or whether widespread pain index (WPI) is between 3 and 6 and severity index reaches 9, ie
FIBROMYALGIA IF ...
(WPI = 7 and SS Score = 5) or
( WPI 3-6, SS = Score = 9)
Wolfe preliminary criteria for improve diagnosis in fibromyalgia, based on patients diagnosed with fibromyalgia with existing criteria that have become obsolete. However, it is closer to current knowledge. Remains to be seen if curd or to stay on the road. The fact of having no objective parameters enthusiasm seems to minimize the progress on fibromyalgia. We should get used ...
- you have fibromyalgia, provisionally.
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