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Wednesday, January 4, 2023

Sesamoid Injury with Vasomotor Skin Changes

https://jamanetwork.com/journals/jamaneurology/fullarticle/796101

     A patient today presented with a sesamoid injury and sympathetic overload signs of vasomotor insufficiency (also called vasomotor dysfunction). This involved his right foot. The sesamoid injury went from mild to totally disabling as the nervous system went wild in an over protective manner. Instead of getting better and better in the last 3 months (the injury is about 5 months old), it is getting worse and worse (only explained by this nervous system issue). He has become less and less active. I opened this post to be a 3-4 month post as I follow his progress. He will be starting Lyrica most likely, and perhaps getting a sympathetic block (which could be done sooner than later). I did not get a photo of his two feet today, but I will ask him to send me one to post. Rich 

Here is the requested photo. This is what the injured right foot and leg look like each afternoon. Most of the time it is better in the morning. Occasionally, if he does too much, he will take 2 days to get back normal. 


Sesamoid, under the first metatarsal, injured 5 months ago is now not the main reason he is having problems. 


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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.