Myofibroblastic lesions in the oral cavity: Immunohistochemical and ultrastructural analysis.

OBJECTIVE: To immunohistochemically characterize a group of oral myofibroblastic lesions (MLs) and to evaluate the ultrastructural features of myofibroblasts. MATERIAL AND METHODS: Using a tissue microarray technique (TMA), cases of myofibroma (MF), of nodular fasciitis (NF), of desmoplastic fibroma (DF), and of myofibroblastic sarcoma (MS) from the Universidad Autónoma Metropolitana Xochimilco, and a Private Oral Pathology Service in Mexico City were stained with antibodies against alpha-smooth muscle actin (α-SMA), H-caldesmon, vimentin, desmin, ß-catenin, CD34, anaplastic lymphoma protein kinase (ALK-1), and Ki-67. RESULTS: Nineteen of the 22 MF cases, 2/5 of the NF cases, 1/10 of the DF cases, and 1/2 of the MS cases were positive for α-SMA. 1/2 of the MS cases were positive for desmin; 6/10 of the DF cases were positive for ß-catenin, and 2 of the MF cases were positive for ALK-1. All of the MLs were positive for vimentin and negative for H-caldesmon and CD-34. The Ki-67 labeling index in all of the 8/22 MF, 3/5 NF, and 2/2 MS cases was ≥10%. For all of the MLs evaluated, ultrastructural analysis revealed spindle-shaped cells containing endoplasmic reticulum and peripheral actin filament bundles. CONCLUSION: In certain myofibroblastic lesions, the use of auxiliary techniques (such as immunohistochemistry) can be critical for differential diagnosis.

Predictive factors for mortality in Fournier' gangrene: a series of 59 cases.

AIMS: Fournier's gangrene (FG) is the necrotizing fasciitis of the perineum and genital area and presents a high mortality rate. The aim was to assess prognostic factors for mortality, create a new mortality predictive scale and compare it with previously published scales in patients diagnosed with FG in our Emergency Department. METHODS: Retrospective analysis study between 1998 and 2012. RESULTS: Of the 59 patients, 44 survived (74%) (S) and 15 died (26%) (D). Significant differences were found in peripheral vasculopathy (S 5 [11%]; D 6 [40%]; P=.023), hemoglobin (S 13; D 11; P=.014), hematocrit (S 37; D 31.4; P=.009), white blood cells (S 17,400; D 23,800; P=.023), serum urea (S 58; D 102; P<.001), creatinine (S 1.1; D 1.9; P=.032), potassium (S 3.7; D 4.4; P=.012) and alkaline phosphatase (S 92; D 133; P=.014). Predictive scores: Charlson index (S 1; D 4; P=.013), severe sepsis criteria (S 16 [36%]; D 13 [86%]; P=.001), Fournier's gangrene severity index score (FGSIS) (S 4; D 7; P=.002) and Uludag Fournier's Gangrene Severity Index (UFGSI) (S 9; D 13; P=.004). Independent predictive factors were peripheral vasculopathy, serum potassium and severe sepsis criteria, and a model was created with an area under the ROC curve of 0.850 (0.760-0.973), higher than FGSIS (0.746 [0.601-0.981]) and UFGSI (0.760 [0.617-0.904]). CONCLUSIONS: FG showed a high mortality rate. Independent predictive factors were peripheral vasculopathy, potassium and severe sepsis criteria creating a predictive model that performed better than those previously described.

[Posterior tibial tendon dysfunction: what other structures are involved in the development of acquired adult flat foot?]. / Disfunción del tendón tibial posterior: ¿qué otras estructuras están implicadas en el desarrollo del pie plano adquirido del adulto?

OBJECTIVE: To evaluate the association of posterior tibial tendon dysfunction and lesions of diverse ankle structures diagnosed at MRI with radiologic signs of flat foot. MATERIAL AND METHODS: We retrospectively compared 29 patients that had posterior tibial tendon dysfunction (all 29 studied with MRI and 21 also studied with weight-bearing plain-film X-rays) with a control group of 28 patients randomly selected from among all patients who underwent MRI and weight-bearing plain-film X-rays for other ankle problems. In the MRI studies, we analyzed whether a calcaneal spur, talar beak, plantar fasciitis, calcaneal bone edema, Achilles' tendinopathy, spring ligament injury, tarsal sinus disease, and tarsal coalition were present. In the weight-bearing plain-film X-rays, we analyzed the angle of Costa-Bertani and radiologic signs of flat foot. To analyze the differences between groups, we used Fisher's exact test for the MRI findings and for the presence of flat foot and analysis of variance for the angle of Costa-Bertani. RESULTS: Calcaneal spurs, talar beaks, tarsal sinus disease, and spring ligament injury were significantly more common in the group with posterior tibial tendon dysfunction (P<.05). Radiologic signs of flat foot and anomalous values for the angle of Costa-Bertani were also significantly more common in the group with posterior tibial tendon dysfunction (P<.001). CONCLUSION: We corroborate the association between posterior tibial tendon dysfunction and lesions to the structures analyzed and radiologic signs of flat foot. Knowledge of this association can be useful in reaching an accurate diagnosis.

Understanding limb necrotizing infections: A comprehensive approach.

INTRODUCTION: Necrotizing soft tissue infections (NSTI) are increasing, posing a significant risk of morbidity and mortality. Due to nonspecific symptoms, a high index of suspicion is crucial. Treatment involves a multidisciplinary approach, with broad-spectrum antibiotics, early surgical debridement, and life support. This study analyzes the characteristics, demographics, complications, and treatment of NSTI in a hospital in Madrid, Spain. METHODS: A retrospective observational study was conducted, including all surgically treated NSTI patients at our center from January 2016 to December 2022, examining epidemiological and clinical data. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) was prospectively calculated for all patients. RESULTS: Twenty-two patients (16 men, 6 women, mean age 54.8) were included. Median time from symptom onset to emergency room visit was 3.5 days. All reported severe treatment-resistant pain; sixteen had fever exceeding 37.8°C (72.7%). Skin lesions occurred in twelve (54.5%), and thirteen had hypotension and tachycardia (59.1%). Treatment involved resuscitative support, antibiotherapy, and radical debridement. Median time to surgery was 8.25h. Intraoperative cultures were positive in twenty patients: twelve Streptococcus pyogenes, four Staphylococcus aureus, one Escherichia coli, and four polymicrobial infection. In-hospital mortality rate was 22.73%. CONCLUSIONS: We examined the correlation between our results, amputation rates and mortality with LRINEC score and time to surgery. However, we found no significant relationship unlike some other studies. Nevertheless, a multidisciplinary approach with radical debridement and antibiotic therapy remains the treatment cornerstone. Our hospital stays, outcomes and mortality rates align with our literature review, confirming high morbimortality despite early and appropriate intervention.

[Translated article] Medial gastrocnemius proximal fasciotomy in patients with chronic plantar fasciitis: A systematic review.

INTRODUCTION: Plantar fasciitis is the main cause of heel pain in middle-aged patients. In chronic cases, limited ankle dorsiflexion caused by isolated gastrocnemius contracture is considered the main risk factor for suffering it. Therefore, in recent years the number of patients operated on by proximal fasciotomy of the medial gastrocnemius (FPGM) has increased to treat chronic plantar fasciitis. MATERIAL AND METHODS: Systematic review following the PRISMA guidelines. We have carried out a bibliographic search in Pubmed, Science Direct, Cochrane Library and Web of Science databases. One hundred and eighty-four articles were found. Data extraction was performed using the Covidence software, and a quality and risk of bias analysis of the included articles was performed based on the Cochrane risk of bias Tool 2.0. RESULTS: Three articles were included in the review: two randomised clinical trials and one cohort study with a total of 138 patients. In the analysed studies, patients after proximal fasciotomy of the medial gastrocnemius showed significant improvements in pain and in the AOFAS score with high levels of patient satisfaction. Increases in ankle dorsiflexion angle were found after 12 months of follow-up, with no loss of gastrocnemius strength. The complication rate was low and fewer occurred in the proximal fasciotomy compared to plantar fasciotomy. CONCLUSION: Proximal fasciotomy of the medial gastrocnemius provides clinical benefit in patients with chronic plantar fasciitis, with a low probability of complications and high patient satisfaction.

An Atypical Manifestation of Necrotizing Fasciitis in a Patient With Type II Diabetes.

In this case report, we discuss a 32-year-old diabetic male patient who presented with right foot pain three days following a spider bite. The foot progressively became swollen, preventing the patient from bearing weight on it. After admission to the emergency department, the examination showed discoloration of the dorsum of the proximal phalanx of the first toe with an open wound and pus. The patient received fluid resuscitation along with a course of metronidazole and levofloxacin. Subsequently, the patient was referred to an orthopedic and podiatric team where he underwent a complete foot fasciotomy. The procedure was successful, and the patient recovered well. This case showcases a rare manifestation of necrotizing fasciitis (NF) and highlights the importance of future research regarding NF and its association with diabetes mellitus.

An Unexpected Turn: Management of a Life-Threatening Infection Following Liposuction Procedure.

This case report presents a rare case of necrotizing fasciitis (NF) following liposuction and lipofilling surgery in a young woman. Despite prompt diagnosis and aggressive management with multiple debridements, broad-spectrum antibiotics, and supportive care, the patient experienced a protracted course with severe complications, including intra-abdominal collection recurrence, heart failure, and sepsis. The presence of resistant bacteria (extended-spectrum beta-lactamases (ESBLs)-producing Escherichia coli and methicillin-resistant Staphylococcus aureus (MRSA)) further challenged the treatment. This case highlights the importance of early recognition and aggressive management of NF, particularly in patients with risk factors following cosmetic surgery. In addition, it raises awareness of the potential for heart failure as a complication in this context and warrants further investigation.

Utility of Shear Wave Elastography for the Diagnosis of Plantar Fasciitis: Comparison Between Symptomatic and Asymptomatic Sides in Unilaterally Affected Patients.

INTRODUCTION: Plantar fasciitis (PF) can cause pain in the heel, which can affect everyday activities. While it often resolves on its own, diagnosing PF to rule out other hind foot conditions by imaging modality in cases of recurrence can be difficult. Methods such as MRI and ultrasonography are helpful, but the use of elastography, specifically shear wave elastography (SWE), as a tool for diagnosing PF is being studied. METHODOLOGY: This comparative observational study included patients over 18 years presenting with unilateral hind foot pain who were investigated using SWE. Exclusions comprised those who were bilaterally affected and with foot deformities, trauma history, or prior injection therapy. Patients' AOFAS Ankle-Hindfoot Scores were assessed along with visual analog scale (VAS) scores, followed by SWE examination of both heels. RESULTS: The study found no significant difference in the plantar fascia thickness between affected and unaffected sides, with a mean thickness of 4.3±0.8mm and 5.1±0.6mm, respectively. Shear wave velocity (SWV) was lower on the affected side, indicating reduced stiffness compared to the unaffected side. The Spearman rank test revealed strong direct correlations between SWV and both the VAS and HF-AOFAS scores on the affected side. CONCLUSION: The study observed that SWE enhances B-mode ultrasonography in detecting early PF even with normal plantar fascia thickness, offering a user-independent and reliable tool for treatment monitoring and correlation with functional and pain scores. Further research with larger populations can aid in developing a clinico-radiological classification system for PF, improving prognostication and treatment guidance.

A Case Report of an Ultrasound-Guided Popliteal Sciatic Nerve Block: An Asset for Emergency Lower Limb Debridement in a High-Risk Patient.

Severe sepsis, a syndrome characterized by systemic inflammation and acute organ dysfunction in response to infection, is a major healthcare problem affecting all age groups throughout the world. Sepsis-associated encephalopathy (SAE) is a common but poorly understood neurological complication of sepsis. It is characterized by diffuse brain dysfunction secondary to infection elsewhere in the body without overt central nervous system (CNS) infection. Such cases commonly present for emergency surgical management with inadequate fasting hours, limited time for preparation, and preoperative optimization. Regional blocks become the savior in such cases where both general and central neuraxial anesthesia become perilous. Here, we present a 70-year-old male, with a case of necrotizing fascitis of the left lower limb with septic encephalopathy, with compromised cardiac or respiratory function and deranged laboratory investigations. The patient was admitted for emergency lower limb debridement, and ultrasound-guided left lower limb popliteal sciatic nerve block along with an adductor canal block was chosen as the plan of anesthesia management.

Necrotizing fasciitis of the thigh secondary to perforated rectal cancer: the sciatic foramen as a route for infective spread.

Necrotizing fasciitis (NF) is a potentially life-threatening surgical emergency. It is a rapidly progressive infection of soft tissues, and mortality is related to the degree of sepsis and the general condition of the patient. It is a rare condition that requires a rapid diagnosis and surgical treatment is aggressive debridement. There are a small number of reported cases of perforation of a rectal malignancy leading to NF of the thigh. We present a case with rectal cancer in which the sciatic foramen had provided a channel for the spread of pelvic infection into the thigh.

La fascitis necrotizante es una emergencia quirúrgica potencialmente mortal. Es una infección de tejidos blandos rápidamente progresiva y la mortalidad está relacionada con el grado de sepsis y el estado general del paciente. Es una condición poco común que requiere un diagnóstico rápido, y el tratamiento quirúrgico consiste en un desbridamiento agresivo. Existe un pequeño número de casos notificados de perforación de neoplasia maligna de recto que conduce a fascitis necrotizante del muslo. Presentamos un caso de cáncer de recto en el cual el foramen ciático fue el canal para la propagación de la infección pélvica al muslo.

A Rare Case of Necrotizing Fasciitis in a Female With Diabetes Mellitus.

Fournier's gangrene (FG) is a relatively rare yet profoundly severe disease. It predominantly affects males; however, mortality rates are comparatively elevated in females. It is a rapidly spreading, life-threatening necrotizing fasciitis that can affect all parts of the body but primarily targets the genital region and the perineum. The clinical presentation is highly characteristic of the disease and is often sufficient for reaching a definitive diagnosis. Common risk factors for the development of this condition include diabetes mellitus (DM), obesity, trauma, alcoholism, smoking, arterial hypertension (which predisposes to obstructive endarteritis), and immunosuppressive disorders, such as HIV and cancer. Prompt diagnosis and treatment are imperative for the prognosis and survival of patients. Herein, we present a case of a 33-year-old woman with a medical history of type 1 diabetes mellitus (treated with insulin), arterial hypertension, and obesity. She presented with pain and swelling in the external genitalia (right labia majora), which later progressed to severe necrotizing fasciitis. The patient underwent surgical debridement and drainage, along with intensive medical therapy.

Comparison of the Effectiveness of Platelet-Rich Plasma Injection Versus Plantar-Specific Calf Stretching Exercises in Patients With Plantar Fasciitis: A Randomized Controlled Trial.

Background Plantar fasciitis is a common foot condition with multifactorial etiology. It is the most frequent cause of heel pain and has been categorized as an overuse syndrome. A clinical examination and history are crucial for diagnosis. There are several different forms of treatment available, two of which are frequently used: physical therapy and steroid injections. Recent research on platelet-rich plasma (PRP) has demonstrated encouraging outcomes and fewer side effects when compared to steroid injections. Methods A randomized controlled trial was conducted and randomization was done of indoor patients into two groups. Group 1, ending with odd numbers, was given PRP injections, and Group 2, ending with even numbers, was advised plantar-specific calf stretching exercises. Visual analog scale (VAS) scores were evaluated before and after the intervention and follow-up was done on the second, sixth, and 12th weeks. Results Comparing the VAS scores between the two groups, we found that in the pre-intervention phase, the VAS score of Group 1 was 5.4±0.56 and that of Group 2 was 5.4±0.59. In the post-intervention phase, the VAS score in Group 1 was 4.6±0.89, while in Group 2 it was 5.2±0.62. In the second week after intervention, the VAS score was observed to be 3.3±0.97 in Group 1, while in Group 2, it was 3.3±0.80. After the sixth week of intervention, the observed VAS score was 2.7±0.78, while in Group 2 it was 2.9±0.82. The mean VAS score after 12weeks of intervention was observed to be 2.3±0.91 in Group 1, while in Group 2, it was 2.2±0.80. Conclusion PRP injections and plantar-specific calf stretching exercises are equally effective in providing pain relief in plantar fasciitis. PRP injections have complications and problems which have been discussed. Exercises are devoid of such complications. No recurrences occurred in the exercise group and four cases had recurrence in the PRP group.

Necrotizing Fasciitis Mimicking Interstitial Cystitis: An Atypical Clinical Presentation.

Necrotizing fasciitis is a severe, life-threatening disease with a nonspecific clinical presentation, making it a challenging diagnosis. Early treatment with broad-spectrum antibiotics and surgical debridement is crucial to prevent rapid disease progression and poor outcomes. Given its high mortality rate and ambiguous presentation, maintaining a high index of suspicion for necrotizing fasciitis is essential. In this case, a 60-year-old woman presented to her gynecologist with urinary tract infection symptoms of frequency, hematuria, and suprapubic pain, with a year-long history of night sweats, hematuria, dysuria, and incomplete voiding. Although initially treated with outpatient antibiotics, she returned to the emergency department one day later with severe lower abdominal pain, overlying erythema, and a high fever. Abdominal imaging revealed extensive cellulitis. Upon the development of rapidly expanding erythema and crepitus, there was concern for necrotizing fasciitis. The patient received immediate treatment with broad-spectrum antibiotics and underwent urgent surgical debridement. While she showed clinical improvement in the following days, laboratory studies revealed profound hypercalcemia, anemia, and persistent leukocytosis. Additional testing ultimately led to the diagnosis of advanced bladder cancer. This case underscores the importance of prompt recognition and treatment of necrotizing fasciitis. It also highlights the influence of confirmation and availability biases, which can lead to overlooking symptoms that may indicate more serious underlying conditions. As medical professionals, it is crucial to remain vigilant and not disregard seemingly insignificant symptoms, as they could be indicative of life-threatening diagnoses.

Fournier's gangrene.

Fournier's gangrene (FG) is a synergistic polymicrobial gangrenous infection of the perineum, scrotum and penis which is characterised by obliterative endarteritis of the subcutaneous arteries, resulting in gangrene of the subcutaneous tissue and the overlying skin. FG affects all ages and both genders, with a male preponderance. It is a rare but life-threatening disease, and despite therapeutic advances in recent years, the mortality rate is 3%-67%, with an incidence of 1:7500-1:750,000. Anorectal, genitourinary and cutaneous sources of infection are the most common causes of FG, with diabetes mellitus being the most common risk factor. The clinical condition presents evolution from 2 to 7 days and is characterised by uneasiness, local swelling and discomfort, fever, crepitus and sometimes frank septic shock. Current imaging techniques for initial evaluation of the disease include radiography, Ultrasonography (USG), Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). However, the diagnosis of FG is usually clinical and imaging can be helpful in uncertain diagnosis and when clinical findings are ambiguous. Treatment of FG is based on a multimodal approach which includes intensive fluid resuscitation to stabilise the patient and correction of electrolyte imbalance, if any. This is followed by extensive debridements and resections in order to remove all necrotic and infected tissue, wide spectrum antibiotics and reconstructive surgery, whenever required. However, despite all the advances in treatment today, FG remains a surgical emergency, hence, early recognition with aggressive haemodynamic stabilisation, parenteral broad spectrum antibiotics and urgent surgical debridement are the mainstay of treatment.

Update on the classification and treatment of localized scleroderma.

Morphea or localized scleroderma is a distinctive inflammatory disease that leads to sclerosis of the skin and subcutaneous tissues. It comprises a number of subtypes differentiated according to their clinical presentation and the structure of the skin and underlying tissues involved in the fibrotic process. However, classification is difficult because the boundaries between the different types of morphea are blurred and different entities frequently overlap. The main subtypes are plaque morphea, linear scleroderma, generalized morphea, and pansclerotic morphea. With certain exceptions, the disorder does not have serious systemic repercussions, but it can cause considerable morbidity. In the case of lesions affecting the head, neurological and ocular complications may occur. There is no really effective and universal treatment so it is important to make a correct assessment of the extent and severity of the disease before deciding on a treatment approach.

Necrotizing Fasciitis of the Abdominal Wall Secondary to Complicated Appendicitis: A Case Report.

Acute appendicitis is one of the most common surgical emergencies worldwide. Many complications can occur secondary to complicated appendicitis including abscess formation, gangrene, sepsis, and perforation, rarely, leading to abdominal wall necrotizing fasciitis. The incidence of necrotizing fasciitis as a complication of ruptured appendicitis is extremely uncommon. The formation of an enterocutaneous fistula leading to this complication further emphasizes the rarity of such occurrence with few cases reported in the literature. Herein, we present a case of abdominal wall necrotizing fasciitis in a 72-year-old female presenting to the local emergency room with complaints of severe suprapubic abdominal pain associated with abdominal distension and acute onset foul-smelling drainage. Physical exam was significant for suprapubic and right lower quadrant abdominal tenderness with associated large indurated tender lesion and purulent weeping with large ecchymosis. Abdominal computed tomography (CT) revealed extensive subcutaneous emphysema, a large cavity with layering fluid extending into the peritoneal space, and a possible fistula formation between the intra-abdominal cavity and subcutaneous tissue. Following the diagnosis of probable necrotizing fasciitis secondary to fistula formation, the patient underwent emergent exploratory laparotomy and extensive debridement of necrotic tissue. In this report, we take the opportunity to highlight the importance of promptly recognizing and treating this uncommon complication and maintaining a high level of suspicion to prevent life-threatening consequences.

Plantar Fasciitis With a Calcaneal Spur.

This study presents the case of a 47-year-old male with right foot plantar fasciitis and a calcaneal spur. Chronic heel pain can be caused by several medical conditions, including plantar fasciitis and a calcaneal spur, which often may be overlooked on initial evaluation. The risk factors, clinical presentation, imaging findings, and emergency department management of plantar fasciitis with a calcaneal spur are reported and discussed.

Autologous Whole-Blood Versus Corticosteroid Local Injection in Treatment of Plantar Fasciitis: A Randomized Single Blind Placebo-Controlled Study.

BACKGROUND: Autologous whole-blood intralesional injection has attracted interest as a possible means of treatment for chronic plantar fasciitis. We contrasted its effectiveness with that of corticosteroids, which have a longer history of success in treating tendinopathies such as plantar fasciitis. In order to monitor the disease's progress naturally, we also compared them with a placebo. METHODS: Sixty clinically diagnosed patients were taken up for intralesional injection of autologous whole blood (AWB), corticosteroid, and normal saline as placebo mixed with 2 mL of lignocaine after dividing them into three groups. Two doses were given and followed up in the third, sixth, and 12th weeks. The evaluation was done according to the visual analog scale (VAS) and the number of tablets of paracetamol (PCM) 500 mg consumed for the following period. RESULTS: When compared to the placebo group in the third, sixth, and 12th weeks, the corticosteroid group exhibited a significant improvement with a p<0.001 in the VAS score, whereas the autologous whole blood group showed no meaningful difference. When compared to the placebo group at the sixth and 12th weeks, the AWB group's VAS score showed a statistically significant difference with a p>0.001. At each follow-up, the placebo group consumed more analgesics than the corticosteroid group, with a p<0.001. Only in the third week of follow-up did AWB demonstrate a statistically significant difference in PCM consumption as compared to the corticosteroid group. CONCLUSION: Statistically significant improvement was seen in both the AWB group and corticosteroid group as compared to the placebo group. The corticosteroid group achieved earlier and superior relief of pain while AWB had a longer lasting effect. Therefore, study results indicate almost similar results in short-term studies.

Not so uncommon, yet neglected 'Severe Streptococcus pyogenes infections at a tertiary care center in south India.

Streptococcus pyogenes (SP) causes uncomplicated infections of throat & skin to severe life-threatening invasive diseases and poststreptococcal sequelae. Despite being common, it hasn't been studied much in recent times. Data of 93 adult patients >18 years, culture proven (SP) infections from 2016 to 2019 was studied in south India. Irrespective of comorbidities, SSTI were most common followed by surgical site infections& bacteremia. Isolates were susceptible to penicillin, cephalosporins but 23% were resistant to clindamycin. Timely surgical interventions and appropriate antibiotics reduced morbidity& limb salvage by 9 times. Larger studies, worldwide, to see the current trend of SP need to be conducted.

The Incidence of Gastrocnemius Tightness Among Clinic Staff in a District Hospital's Clinic in the State of Kedah, Malaysia.

Aim Musculus Gastrocnemius Tightness (MGT) has been linked with common foot and ankle pathologies. These symptoms sometimes are not severe enough for the patient to seek treatment. This study aims to determine the incidence rate of MGT among our clinical personnel and if there is any association between foot and ankle symptoms with MGT. Materials and methods This observational cross-sectional study involves clinical personnel from our Specialist Clinics at Hospital Kulim, Malaysia. We interviewed and assessed 85 volunteers of which, we measured the passive ankle dorsiflexion of the volunteers (the Silfverskiöld) test, to diagnose MGT. We then used the Manchester Oxford Foot Questionnaire (MOxFQ) is used to determine the functional outcome of our volunteers. Results Out of a total of 85 volunteers assessed, 12 (14%) volunteers were found to have gastrocnemius tightness. Among this cohort, 11 were symptomatic. Out of the 73 who did not have MGT, there were three symptomatic volunteers. There was a significant association between volunteers with foot and ankle symptoms with gastrocnemius tightness, compared to those without. There was a significant difference in the relationship between the MOxFQ scores in all components (walking, pain, and social) when comparing those with and those without MGT. Conclusion We conclude that there is a significant association between foot and ankle symptoms and MGT in our clinic sample population. However, these symptoms were not severe enough for these symptomatic volunteers to seek treatment. We should consider screening symptomatic staff and implementing stretching protocols.