PODIATRY

All We Ever Hear is FAT is BAD!

Here is an interesting little condition that frequently prompts a call for an urgent diagnostic office visit.

Usually, the story starts with a barefoot or poolside encounter. Someone looks down and utters the, OH My! What are those pale lumps on your feet? Upon further examination, more of the concerning nodules are identified. 

They are present in all of us to varying degrees but generally remain concealed deep to the dermis layer(deep skin layer). Often they will completely disappear from sight when the foot is non-weight bearing.

They are a very cleverly designed layer of fibrous nodules encapsulating fatty tissue. They behave collectively as adaptive shock absorbers, but due to their individual nature, can adapt to sharp objects lessening the likelihood of puncture. For certain individuals, the dermal layer appears more transparent, fat pad extends higher, or in others faulty biomechanical forces cause the tissue to protrude more in one direction causing the nodules to appear.

Generally, they remain asymptomatic requiring nothing more than an explanation of their presence and reassurance that the sky is not falling. Occasional, their presence when combined with significant functional instability produces mechanical irritation, inflammation, swelling and fibrous tissue formation.

So what do we do?

Ok if you’ve read past blogs, you’ll know the first step will be identifying the origin of the functional instability. Despite having first identified and then addressed the source of the mechanical irritation, the discomfort persists!. Then we may suggest injection therapy or simple surgical excision. Removal is usually uncomplicated as the site of the incision is non-weight bearing and when done carefully with good post-operative patient compliance there is minimal scar formation.

Not knowing is Always worse, being informed and prepared to make the best decision for YOUR needs is Better.

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