Comments for Handbook of Lower Extremity Infections

Comment on Antibiotic Prescribing in Podiatric Medicine by Ribotsky

Ribotsky — Tue, 24 Jan 2012 22:13:36 +0000

Warren,
Your wit and knowledge are the beacons that guide my use of ABX’s and thanks to you, my patients have enjoyed the benefits. Keep up this Blog, You are helping many many many patients.
Thank You.

Bret

PS Many can listen to the words of Dr. Joseph at http://www.PodiatricSuccess.com

Comment on Region IV Book Signing by Warren S. Joseph DPM FIDSA

Warren S. Joseph DPM FIDSA — Mon, 24 Oct 2011 19:27:39 +0000

I think that you can make the argument that ANY ulcer/lesion will effect ambulation, especially plantar lesions. Remember that a plantar lesion is caused by repetitive trauma/pressure. Any ambulation could keep it from healing. That is why off-loading is so important in the treatment of these lesions. If you have a more specific question about a location please feel free to ask. Thank you for the comment

Comment on Region IV Book Signing by aturner

aturner — Wed, 19 Oct 2011 20:55:55 +0000

What level of diabetic ulcer and/or lesion effect a patients ambulation.

Comment on What Would You Do? – Imaging for Osteomyelitis by Levi

Levi — Fri, 27 May 2011 19:17:23 +0000

Lacking clinical signs of infection and in suspicion of noncompliance, I would get radiographs, due to their clinical relevance and easy access. If a set of radiographs was negative as well, I would continue to treat the ulcer based on the clinical presentation. You could pursue more expensive tests to protect yourself legally, but if there is no clinical sign of infection, then from a medical standpoint what is prompting the test. In short I think your treatment should be guided by clinical suspicion and medical standard of care first. That being said, we live in an extremely litigious society and as a medical practitioner, protecting your assets is also a reality, so further investigation might just come down to whether you live in Philadelphia versus Brush prairie.

Comment on What Would You Do? – Imaging for Osteomyelitis by Steven Klein

Steven Klein — Tue, 03 May 2011 18:11:30 +0000

Monthly plain films x 2, then Q 60 D as long as clinical picture does not worsen. MRI or nuclear studies only to confirm clinical suspicion of OM.

Comment on What Would You Do? – Imaging for Osteomyelitis by Ribotsky

Ribotsky — Tue, 03 May 2011 16:06:21 +0000

I use my “Harry Potter” magic wand and if there is an infections it is
drawn magically to the area. (Outside the box enough ?)

In my community, its MRI, and if that does not help, then CT guided bone biopsy. Of course, I still like x-rays, but the radiologist
always request MRI before they will say its osteo……

Be well,
Bret

Comment on What Would You Do? – Imaging for Osteomyelitis by dmd31842

dmd31842 — Tue, 26 Apr 2011 09:06:03 +0000

Weight-bearing radiographs to fully evaluate biomechanics in order to determine the proper shoe/orthotic.
No need for further imaging as there are no signs of deeper infection

Comment on What Would You Do? – Imaging for Osteomyelitis by jxcarrel

jxcarrel — Mon, 25 Apr 2011 16:45:14 +0000

If serial X-rays negative, and no clinical signs, eg tunneling, no further imaging

Comment on THE 80% SOLUTION (With apologies to Sir Arthur Conan Doyle) by Jeff carrel

Jeff carrel — Sat, 26 Feb 2011 14:28:47 +0000

Warren …..thanx for the well stated, balanced explanation …..as usual your comments are scientifically accurate and well stated, a plus for the profession.Thanx, jeff

Comment on THE 80% SOLUTION (With apologies to Sir Arthur Conan Doyle) by Steven Klein, DPM

Steven Klein, DPM — Sat, 26 Feb 2011 05:57:54 +0000

Gee, I guess the chicken soup didn’t really cure my flu, since I got it twice this year. Hypothesis: Go barefoot or replace all contaminated shoes and “cure” rates will go up.