Why won't this sore on my leg heal? [return
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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
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.