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plantar fibroma and cortizone Q *again*

Posted by Donald on 1/30/03 at 21:51 (107431)

Ok im going back for my 3rd cortizone shot im my foot for a planter fibroma. 2nd shot only lasted me a month, first shot lasted 4 months. both times after getting shot my ankel felt swollen, like a sprain the next day and lasted for about a week. My DPM says she doesnt know why and has never heard of tthat happening o anyone. is this some sort of reaction/Allergy to cortizone or is this something that is a side effect?

Also my PF has more than doubled in size in the past month and my Dr was concerned and told me a biopsey of it might be needed for further investagation. Ive told them i would think about it and get back to them sometime next week with what i wanta do. is an biopsey really nessisarry? i thought it was just a benine tummor and the lump was mostly just scar tissue. my understanding is a benine tummer doesnt spread, a meligment tummor does. i thank you for any help, and for reading all my spelling mistakes.

Re: plantar fibroma and cortizone Q *again*

Dr. Z on 1/31/03 at 07:49 (107463)

Get an mri first. Ths ankle sprain feeling ? Not sure could be a local reaction from the steriod. But get the mri first.

Re: plantar fibroma and cortizone Q *again*

Dr. David S. Wander on 1/31/03 at 13:19 (107486)

Dr. Z has an excellent suggestion to recommend an MRI prior to a biopsy of the lesion. This is in an effort to avoid a potentially painful scar on the bottom of your foot. However, although MRI's are very useful and can determine the characteristics of the lesion, a biopsy in the only definitive way to obtain a diagnosis. Discuss this with your treating doctor.

Re: plantar fibroma and cortizone Q *again*

Ed Davis, DPM on 1/31/03 at 19:39 (107529)

Donald:

Patients with pain in the arch/heel area often shift weight to the outside of their feet and that can cause some lateral ankle strain. It is possible that after the shot, you, without thinking about it, shifted weight to the outside of your foot.

Keep in mind that there is no such thing as 'cortisone.' That term refers to a number of different substances that are often collectively referred to as 'cortisone.' Different forms of such steroids have different effects. I have found that if the goal is to shrink a plantar fibroma, the best combination of substances is triamcinolone acetonide (a type of 'cortisone') plus Wydase ( an enyme that shrinks scar tissue, AKA hyaluronidase). If your doc tried a less potent formula, he may want to retry the injection with the above.
Ed

Re: plantar fibroma and cortizone Q *again*

Donald on 1/31/03 at 20:04 (107534)

Thanks for all your help. now that i think of it i was walking on the outer side of my foot. i will ask my Dr's what type of cortisone shot ive been getting and ask if i can try the combo you have mentioned. And do you know of any good DPM's in the Boston MA area? Thanks

Ill probly be back with more questions later on =)

Re: plantar fibroma and cortizone Q *again*

Dr. Z on 1/31/03 at 07:49 (107463)

Get an mri first. Ths ankle sprain feeling ? Not sure could be a local reaction from the steriod. But get the mri first.

Re: plantar fibroma and cortizone Q *again*

Dr. David S. Wander on 1/31/03 at 13:19 (107486)

Dr. Z has an excellent suggestion to recommend an MRI prior to a biopsy of the lesion. This is in an effort to avoid a potentially painful scar on the bottom of your foot. However, although MRI's are very useful and can determine the characteristics of the lesion, a biopsy in the only definitive way to obtain a diagnosis. Discuss this with your treating doctor.

Re: plantar fibroma and cortizone Q *again*

Ed Davis, DPM on 1/31/03 at 19:39 (107529)

Donald:

Patients with pain in the arch/heel area often shift weight to the outside of their feet and that can cause some lateral ankle strain. It is possible that after the shot, you, without thinking about it, shifted weight to the outside of your foot.

Keep in mind that there is no such thing as 'cortisone.' That term refers to a number of different substances that are often collectively referred to as 'cortisone.' Different forms of such steroids have different effects. I have found that if the goal is to shrink a plantar fibroma, the best combination of substances is triamcinolone acetonide (a type of 'cortisone') plus Wydase ( an enyme that shrinks scar tissue, AKA hyaluronidase). If your doc tried a less potent formula, he may want to retry the injection with the above.
Ed

Re: plantar fibroma and cortizone Q *again*

Donald on 1/31/03 at 20:04 (107534)

Thanks for all your help. now that i think of it i was walking on the outer side of my foot. i will ask my Dr's what type of cortisone shot ive been getting and ask if i can try the combo you have mentioned. And do you know of any good DPM's in the Boston MA area? Thanks

Ill probly be back with more questions later on =)