Edward J. Shahady, MD

Up to 10% of Americans older than 20 years have type 2 diabetes, and more than 20% have the metabolic syndrome. The prevalence of both diseases has risen by 33% over the past decade as a result of an increasingly sedentary lifestyle, the obesity epidemic, the growth of ethnic groups at risk for the disease, and the aging of the population.

A 17-year-old student complains of worsening pain on the lateral side of his right foot that began 2 weeks earlier and now causes him to limp.

A 55-year-old right-handed house painter has had a constant dull ache in his right shoulder for 3 weeks. The pain worsens when he steers his car or elevates his arm, and the inability to raise his arm above his head interferes with his work.

For 4 weeks, a 23-year-old runner has had a painful burning sensation about 1 inch above andlateral to the left knee cap. Occasionally, the pain radiates to her hip and 1 inch down the lateralside of her leg.

A healthy 23-year-old woman, who is a longtime runner, calls your office the day after shetripped on a tree root while running in the woods and twisted her right ankle. She noted immediatepain on the lateral side of the ankle but did not hear or feel a pop. She was able tobear weight and walked out of the woods. However, as she walked, the ankle became morepainful and began to swell. When she reachedhome, she applied a heating pad and restedthe ankle. The next morning she noted increasedswelling and moderate discomfortwhile walking.