The Center for Podiatric Care and Sports Medicine

Do Your Feet Show Signs of Undiagnosed Disease?

Posted by on Monday, June 15th, 2015

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NY podiatrists perform a comprehensive examination of all body systems to get to the root of your foot problem. So it’s no surprise that podiatrists are often the first doctors to diagnose afflictions such as arthritis, diabetes, thyroid or peripheral artery disease. Foot doctors sometimes order further tests like x-rays, CT scans, MRIs, or blood studies.

“Foot doctors are often overlooked as patients set up a primary medical care team,” says Dr. Josef J. Geldwert, DPM. “Yet, we work closely with primary care physicians, dermatologists, cardiovascular specialists and neurologists in the diagnosis and treatment of diseases that manifest themselves in different ways — including tell-tale signs in the feet.” He explains that the first goal of his podiatric team is to conduct a thorough assessment and obtain an accurate diagnosis. From there, they seek to immediately rectify the patient’s pain and suffering, and then treat the root cause of the issue.

Here are 10 of the most common undiagnosed diseases the team at The Center for Podiatric Care and Sports Medicine come across in New York City.

foot disease
Extremely high arches and curled toes could be a sign of Charcot-Marie-Tooth Disease, say NY podiatrists. Image Source: MDA.org

1. Thyroid Problems

Symptom: Dry feet

Sometimes flaky feet are just a matter of needing a heavy duty moisturizer. If the feet show severe cracking or dryness that does not improve with the use of a moisturizing agent, then we may refer patients to their primary doctor to make sure the thyroid gland is producing enough hormones.

2. Peripheral Artery Disease

Symptom: Hairless toes

PAD causes poor circulation that manifests as purplish colored toes, thin and shiny skin, and a sudden decrease in hair growth on the feet and ankles. We can detect artery problems by taking a pulse in the foot and ordering an x-ray. If we see hardened arteries in the feet, there is a corresponding hardening of the heart blood vessels 99% of the time.

3. Diabetes

Symptom: Non-healing foot wounds

Uncontrolled glucose damages nerves and reduces circulation, which delays healing when a foot is injured with a blister or other type of wound. At more advanced levels, patients report coldness, tingling or numbness in their feet. In these cases, we recommend a blood sugar level test to diagnose diabetes.

4. Gout

Symptom: Swelling and pain in the big toe

Gout is the most painful form of arthritis, but unlike other types that are pervasive and constant, gout typically affects the big toe joint temporarily. The condition usually “flares up” when predisposed patients eat an overabundance of purines — a chemical compound found in alcohol, red meat, and fish. When the body’s uric acid levels got too high and cannot be excreted through urine, it forms crystal deposits in the toe or sometimes the ankle joint.

5. Endocarditis

Symptom: Broken blood vessels beneath the toenails

Endocarditis is an infection of the heart’s innermost lining that causes blood clots to form, which damages capillaries under the nails. When there has been no obvious trauma to the nail, but splinter hemorrhages occur, we may be suspicious of this disease — especially among patients who have a pacemaker, HIV patients, diabetics, or those undergoing chemotherapy.

6. Lung Cancer

Symptom: A rounding and widening of the toes known as “clubbing”

Heart Disease and Lung Cancer both prompt decreased blood flow to the arteries in the toenails and fingertips, causing tissue swelling that gives patients the appearance of rounder, wider fingers and toes. By the time clubbing occurs, most patients are already aware that they have the disease, but occasionally, we find patients who admit they’ve been putting off a trip to the primary care doctor.

7. Psoriasis

Symptom: Pitted nails

Holes, ridges or grooves in the toenails are often an indication of psoriasis, an autoimmune disease affecting the skin and nails. Other symptoms include horizontal lines or white patches across the nails. Most people with psoriasis will suffer dry, red, irritated patches on their faces, scalps, palms, soles, elbows or knees. About 5% of patients are only symptomatic on the nails and come in believing they have toenail fungus.

8. Lupus

Symptom: Spoon-shaped nails

Spooned nails may appear in infants, but straighten out sometime in the first few years. However, nails do not begin to change shape later in life unless there is some type of issue like an iron deficiency (anemia), overproduction of iron (hemochromatosis), or immune system response that attacks and damages the cells of the nails (lupus). A blood test can help clear up the source of this nail complication.

9. Skin Cancer

Symptom: A dark vertical line under the toenail

Less than 10% of melanoma cases are hidden under the nails, but we occasionally observe a black line extending from the base of the nail to the tip. Although hidden melanomas are relatively rare, it is the most common type of skin cancer in dark-skinned patients. If there are yellow or brown spots peppered throughout the nail, then it may be toenail fungus.

10. Charcot-Marie-Tooth

Charcot-Marie Tooth is an inherited disorder in which damage to the brain and spinal cord nerves cause changes in gait, foot drop, muscle atrophy, in the lower limbs, difficulty with balance, numbness in the feet, and difficulty with fine motor skills in the hands. Changes in the foot often include toes that arch upward (hammer toes) and arches that thin out or become extremely high.

Make New York City Podiatrists Part of Your Health Care Team

Many people only seek attention from a podiatrist when they are suffering from a serious issue that cannot be ignored. While we do have all the necessary diagnostic tools at our disposal, consider visiting us once a year  for a regular examination to keep tabs on your overall health and ensure that you remain as mobile as possible, well into old age. In addition to diagnosing and treating foot problems, we can also show you preventative maintenance steps to take such as flexibility and strength training exercises and counsel you on footwear selection. Should you require advanced therapy, The Center for Podiatric Care and Sports Medicine is equipped with everything from non-invasive pain-reducing lasers and shockwave therapy to platelet rich plasma injections and hyperbaric oxygen chambers. Contact us for more information.

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.