Anticoagulants and dry needling/acupuncture

So, I had a patient come in on Xarelto (rivaroxaban) requesting acupuncture. And my gut instinct said, "Hell no", but I thought I'd check the literature first.

And it turns out, anticoagulants aren't an absolute contraindication to dry needling. There are a couple of clinical guidelines for physiotherapists using acupuncture that talk about avoiding joints and using finer gauge needles (e.g. Australian Society of Acupuncture Physiotherapists - www.acupuncturephysio.org)

But there's an interesting paper where they compared patients on warfarin, patients on antiplatelet therapy and patients on nothing interesting and they didn't seem to have many more complications:

Young-Jee Kim, Soo-Kyung Kim, Seung-Yeon Cho, Seong-Uk Park, Woo-Sang Jung, Sang-Kwan Moon, Chang-Nam Ko, Ki-Ho Cho, Sang-Beom Kim, Won-Chul Shin, Jung-Mi Park. Safety of acupuncture treatments for patients taking warfarin or antiplatelet medications: Retrospective chart review study. Eur J Integr Med 2014;6:492–496.

Here's a commentary:
http://www.sciencedirect.com/science/article/pii/S2213422015000256

PTTD: handy reference graph awaits:

http://www.orthobullets.com/foot-and-ankle/7020/posterior-tibial-tendon-insufficiency-ptti

There's a great table in this article on staging. Thanks Orthobullets!

A lovely little overview on managing diabetic foot infections...

A lovely little overview on managing diabetic foot infections...

http://www.australianprescriber.com/magazine/30/1/21/4

I really liked the "if it smells add metronidazole" option: nice clinical tip on helping to recognise coliform/gram negative involvement in terms of empiric therapy prior to getting swab results back. Not sure about it being evidence based but it sounds like a nice idea in theory - any thoughts?

How feet grow: a selection of abstracts

So I thought I was going to get to see a little tacker with a 2-size difference in foot length. Turns out they saw someone else, but in the process I came across these few interesting articles:

Foot Growth in Children Age One to Five Years

Foot & Ankle International February 1990 vol. 10 no. 4 211-213 by Gould et al.

The Lowdown: 

Kids feet grew: 1/2 a size in less than 2 months up till 15 months old

1/2 size in 2-3 months from 15-24 months

1/2 size every 3-4 months from 2-3 years

1/2 size every 4 months from 3-5 years

Boys feet were on average 1 size longer and wider than girls. Width and length growth were proportional.

Next:

Foot Growth Rate in Children Age One to Six Years*

Foot & Ankle International January 1983 vol. 3 no. 4 207-210  By Wenger et al.

They used to think shoe size changed every 1-2 months from 2-6 years:

Their study showed a size change (I assume a half size?) every 2-3 months from 12-30 months then 4 months 30-48 months then 6 months 4-6 years.

Intro

So I keep coming across all these articles that I lose track of when I'm looking into stuff for clinical cases and things, and I thought, hey, there aren't enough blogs in the world, especially not enough blogs about foot stuff, and looking at foot stuff counts as CPD in the foot land that I live in at the moment.

So I thought I'd start a blog. All the cool kids are doing it. Read along if you want, but please don't take it as gospel.

E.