Podiatric Pathology Services
Providing Unmatched Podiatric Services to Podiatrists and Their Patients
Sagis’ board-certified podiatric pathologists have trained at world-renowned institutions, allowing us to provide unmatched podiatric pathology services to podiatrists and their patients. We utilize the latest techniques in histology, molecular pathology, fluorescent in-situ hybridization, and epidermal nerve fiber density testing to ensure the most accurate diagnosis possible, delivered through clear and concise reports.
Podiatric Pathology & Diagnostic Services from Sagis
Our routine podiatric pathology services have a turnaround time of 24-48 hours. Cases requiring immunohistochemical staining or other testing usually have a turnaround time of 48-72 hours.
We perform comprehensive testing in order to diagnose all diseases related to skin and soft tissue, nails, and bone, assessing for all neoplastic, inflammatory, and infectious conditions affecting the lower extremities, ankles, and feet.
Skin & Soft Tissue Evaluation
Our team of pathologists are experts in diagnosing diseases of soft tissues, muscle, and bone disorders.
In addition to conventional histology assessment, we utilize a complete array of immunohistochemical, cytogenetic, and molecular tests to provide the most accurate diagnosis possible.
Onychodystrophy / Onychomycosis
Our detailed reports contain information regarding the precise nature of fungal infections. They are specifically tailored for podiatrists, containing information regarding:
- Dermatophyte, saprophyte, and yeasts
- The quantity and distribution of subungual and total dystrophic nail plate involvement
- Coinciding and predisposing conditions such as inflammatory dermatoses (examples include— dyshidrotic eczema, contact dermatitis, and psoriasis)
- Acute trauma or micro-trauma
- Onychoschizia – a pathological splitting of the nail plate
Nail Unit Evaluation
Our nail unit evaluation service provides diagnoses for a wide range of conditions affecting the nail. Nail matrix biopsies allow Sagis pathologists to analyze for diseases of the nail plate, including but not limited to:
- Distinguishing inflammatory conditions such as nail psoriasis and lichen planus
- Identifying benign tumors like viral warts, melanocytic nevus (mole), and onychomatricoma
- Determining the cause of a longitudinal melanonychia (a pigmented band in the nail plate), which may be due to a benign pigmented lesion or melanoma of the nail unit
- Diagnosing malignancies such as squamous cell carcinoma
Our polymerase chain reaction (PCR) testing services are optimized for detecting various disease-causing agents, including bacteria and fungi. We provide a 24-hour turnaround time on qPCR Wound Testing for:
- Gram-Positive Bacteria
- Gram-Negative Bacteria
- Antibiotic Resistance Markers
- Arkstone Treatment Guidance
We offer rapid results for bone biopsies and bone resection specimens through both traditional histological examination and molecular (bacterial) PCR analysis to identify bacterial species with antibiotic resistance gene reporting.
Our wound testing services combine traditional histology with special stains (PAS/GMS/FM) and molecular PCR analysis for bacterial and fungal species identification. This method provides the utmost sensitivity, which optimizes the treatment options for the patient.
Sagis Cytology services are tailored to meet the specific needs of podiatrists and their patients, encompassing both joint fluid cytology and cyst cytology.
Joint Fluid Cytology:
Our board-certified pathologists have extensive experience in the examination of joint fluids and synovial fluids for crystals – specifically gout and pseudogout.
Additionally, in cases where a significant number of inflammatory cells are found, our team will suggest and can perform supplementary in-house culture testing. The information provided allows podiatrists to make informed decisions regarding treatment, which leads to improved patient care.
Our pathologists are also experts in the cytologic evaluation of cyst contents, which helps to categorize the lesion accurately and leads to appropriate treatment.
Epidermal nerve fiber density (ENFD) testing can lead to a more accurate diagnosis of the underlying cause of neuropathy. This is why each case is read by one of our board-certified dermatopathologists, in addition to distinguished board-certified neuromuscular neurologist Dr. Todd Levine, founder and CEO of the esteemed Corinthian Reference Laboratories (CRL).
Our dermatopathologists check for any evidence of small vessel vasculitis or other histologic abnormalities, and Dr. Levine meticulously examines each biopsy’s epidermal nerve fiber density to guarantee a highly sensitive and specific analysis of sensory nerve function.
Specimens and Panels
Accepted Specimen Types:
- Tissue Shaves
- Bone Samples
- Onychomycosis (PAS, GMS, FM, PCR)
- Molecular panels for wound and nail PCR
- Nail unit for trauma and pigmented streaks or lesions
- Skin & soft tissue for melanoma, verruca, vasculitis, dermatitis, tinea, cysts, abscess, tophus, and lipomas
- Aspirates for gout or cysts and cytology
- Bone to confirm osteomyelitis