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2164-1-1-3 EdemaLower extremity edema can be broadly catego-rized into generalized and localized types. Local-ized edema is mainly associated with foot lesions and includes lymphedema, venous edema, and disuse edema14）. In recent years, an increasing number of patients tend to present with disuse edema due to loss of muscle strength and reduced ADL15）. Medical treatment is prioritized in patients with systemic edema; however, lower extremity edema requires appropriate management under the guidance of a specialized department.Edema-induced skin thinning causes dryness, a decline in the natural skin barrier function, and itchiness, which trigger scratching and predispose patients to infection after even minor wounds, resulting in cellulitis. Prolonged untreated edema can lead to fibrosis of the skin and loss of flexibility, which may result in joint contractures and motor dysfunction. Additionally, worsening edema can lead to intractable ulcers secondary to leakage of water that cannot be stored under the skin. Venous edema caused by varicose veins or impaired venous return typically manifests at the skin around the ankle joint, which shows pigmentation, leading to blistering, erosions, and stasis ulcers. Stasis ulcers produce a large amount of effusion and are painful and significantly negatively affect patients’ quality of life (QOL)16）. Use of elastic stockings is encour-aged for management of lymphedema to avoid enlargement of the lower extremities and gait diffi-culties, which negatively affect QOL and ADLs17）. The degree of lower extremity edema varies with the duration of lower extremity weakness and the extent of activity. The foot size tends to fluctuate within the day, which can cause shoe-induced chafing, bedsores, and ingrown toenails. Further-more, the increased weight of the lower extremity secondary to edema can cause gait difficulties and predispose the patient to falls.Evaluation should be performed to determine the cause of the edema (systemic vs. localized). Screening for heart failure, liver and renal disease, hypothyroidism, and anemia is necessary to confirm systemic edema. Following exclusion of systemic edema, the cause of edema should be investigated using ultrasonography to measure venous return and, if necessary, lymphatic scintigraphy. Edema-tous feet may be scarred and show continuous subcutaneous fluid leakage. Even minor wounds may lead to cellulitis and should be closely moni-tored. Careful evaluation is necessary to determine patients’ range of motion and gait disturbances, if any, caused by skin fibrosis.4-1-1-4 DeformitiesIn addition to trauma- or fracture-induced defor-mities, foot deformities may be associated with osteoarthritis, rheumatoid arthritis, diabetic neurop-athy, other peripheral neuropathies, aging, and use of inappropriate footwear. Foot deformities can lead to abnormal load balance during walking and cause calluses and clavus.Metatarsalgia, an inward deformity of the first metatarsal bone is more commonly observed in women and is associated with rheumatoid arthritis, genetic factors, flat feet, weakness of the foot muscles, and inappropriate footwear18）. Progressive metatarsalgia is characterized by severely deformed and overlapping toes and causes difficulty with wearing shoes and walking. Hallux valgus, which is often mistaken for hallux valgus. Hallux valgus is characterized by callus formation on the dorsal aspect of the metatarsophalangeal joint of the first toe. Bunions tend to develop on the lateral aspect of the foot owing to footwear-induced friction, and a callus or clavus is often observed on the lateral aspect of the fifth toe. Hammertoe or claw-toe deformity is associated with diabetic neuropathy or inappropriate footwear, which results in calluses and clavus involving the proximal interphalangeal joint and tip of toes.A flatfoot deformity is commonly observed in children and elderly individuals. Disruption of the arch structure, which causes a flatfoot deformity, is primarily caused by foot muscle weakness, with consequent plantar tendonitis and plantar fasciitis, which result in chronic pain and impaired walking ability19, 20）.Charcot foot is characteristically associated with diabetic neuropathy (Figure 3) and occurs secondary to the accumulation of small fatigue fractures in the foot21）. Patients with diabetic Charcot foot are considered to have developed peripheral neurop-athy, which clinically presents with reduced warmth and pain sensation, and ulcers resulting from calluses and shoe abrasions are often detected late and tend to become serious.