Diabetes Lecture

Here is a video of a lecture that was given to endocrinologist fellows at UMass University Campus in Worcester Massachusetts.  This lecture will go over the common foot problems in diabetes.  I hope you enjoy.


Hallux Limitus


Here is an example of a foot with hallux limitus.  All that means is that the great toe joint does not bend as normal due to the arthritis that has formed in that area.  Here is an x-ray that shows an example of this arthritis.
You can see on this x-ray that the bone spur has been removed.  That is one of the treatment options.  If you want to learn more about treating this condition here are some more resources.


To your health,
Dr. Donald Pelto

Flat feet



If you have flat feet you may want to see what your x-ray would look like.  Here is a typical x-ray of a person with a flat foot and a normal foot.  You can see a few lines that are drawn on the x-ray to show some measurements.  The two lines that area parallel are on the normal foot and the two crossed lines are on the flat foot.  However, the easiest area to look at is the heel position.  Do you see how the heel is flat to the ground and not elevated upward as a normal foot would look.  

If you would like to learn more about flat feet and kids here is a video I put together.


To your health,
Dr. Donald Pelto

Dark color of nail, what to do?


Some patients around Worcester Massachusetts come into the office because their big toenail is changing color.  You can see this nail has a dark brown line in the center of the nail.  This is usually nothing to worry about and is caused by the natural pigment in the skin under the nail.  Sometimes though this can be concerning and a melanoma of the nail base.  To be on the safe side a nail biopsy can be taken of the skin under the nail to make sure there are no problems.  

To your health,
Dr. Donald Pelto


V is for victory unless you have a neuroma


Here is an example of a patient of mine and you can see in the x-ray there is a "V" between the 3rd and 4th digit.  There are many things that can cause the toes to spread but one common problem is a neuroma.  A neuroma is a thickening of the nerve that feeds the adjacent sides of the 3rd and 4th digits.  When this nerve gets squished between the bones in that area it gets thicker and thicker with scar tissue.  Soon the nerve takes up more space and causes the toes to spread out.  This is call the "V" sign.  By this time most patients need surgery to remove the nerve if it is painful.  However, for many people this doesn't even hurt but only looks funny.  

To learn more about neuromas look at this webpage:

To your health,
Dr. Donald Pelto

Fold your bandaid to come off easy


I had a patient of mine come to the office the other day after having an ingrown toenail procedure.  This patient gave me a nice tip that I wanted to pass on to other patients about folding over the tip of the band-aid.  If you have problems getting band-aids off try to fold over the end of the band-aid that way it won't stick and will come off easier.  

To your health,
Dr. Donald Pelto

Painful great toe


Here is an example of a patient with a painful great toe joint.  As you can see by the picture in the great toe joint there are spurs on the inside of the joint as well there is less space for the joint that is why the joint looks like it is bone on bone.  The technical term for this condition is Hallux Limitus.  This condition causes pain in the great toe joint when squatting or kneeling and tends to get worse over time.  It is an osteoarthritis problem of wear and tear of the joint.  There are many types of treatment including cortisone injection, orthotics and surgery.  If you are interested in learning more about this condition and how to treat it you can read more here:
To your health,
Dr. Donald Pelto