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Differential Diagnosis

Recognition of ainhum should cause no problems either clinically or radiologically. Leprosy can cause amputation of a phalanx, but it seldom affects only one digit or one bone. There are almost always other manifestations of the disease in the foot. Other neurovascular or arthritic diseases, such as psoriasis and scleroderma, may rarely mimic ainhum, but these will show more generalized changes in the foot, and the deformities are seldom confined to one or two digits. Ainhum is unlikely to be confused with idiopathic spontaneous gangrene (q.v.) which affects more than one digit and starts at the tip. Transkei foot, a disorder found in the Xhosa people of the Transkei, is characterized by marked lateral deviation of the fifth toe; it may be of genetic origin and lacks the other features of ainhum.

Ainhum is a unique disease and is usually a very easy one to diagnose and to treat; the satisfaction would be complete if we knew what caused it!

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Copyright: Palmer and Reeder

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