Why won't this sore on my leg heal?   [return to the list of articles]

Chronic sores on the legs can be from many sources. The two most common sources are venous insufficiency or arterial insufficiency.

In venous insufficiency blood "pools" in the lower legs causing swelling, discoloration and pain. Occasionally an ulcer appears when infection develops. Treatment of these venous sores is accomplished by reducing the swelling, controlling the infection and treating the wound. Many options for wound treatment exist ranging from special dressings to artificial "skin" called apligraf.

In arterial insufficiency, blood cannot get to the legs or feet due to "hardening of the arteries". the main symptoms of arterial insufficiency are pain when walking, cold feet, or non-healing sores. simple ultrasound tests called Doppler studies can estimate the degree of blockage. If needed, arteriograms are performed to give the actual "roadmap" of the blockages.

Depending on the type and extent of the blockage, it can be treated medically, with balloon angioplasty, or with a surgical bypass to promote wound healing.

Another common problem with the thyroid gland is nodules or tumors. In the past, due to poor intake of iodine, large goiters were more common. Now, with the use of iodized salt and the increased consumption of fish (especially shellfish) these types of goiters are less common but still do exist. Most nodules or lumps in the thyroid are benign nodular goiters and can be easily treated or suppressed with synthroid. Occasionally, goiters can become very enlarged and cause difficulty in swallowing or breathing. If this occurs, surgical removal of the thyroid gland is indicated.

Most nodules in the thyroid are benign goiters. However, thyroid cancer can occur. Whenever a lump is found in the gland, it is important to make sure that it is not a cancerous growth. The way to evaluate a nodule is for a surgeon to perform a fine needle aspirate or a core needle biopsy of the lump. This is done in the surgeon's office with local anesthesia. Depending on the results of these procedures, medical management may be sufficient or surgical intervention may be necessary.

If one of these nodules is cancerous, surgical removal of part or all of the thyroid gland is performed and/or the drinking of the iodine "cocktail" easily curing most cancers.

For further information about thyroid disease or thyroid nodules contact our office at 570.459-5607.

-- Anthony M. Carrato, M.D.