4- Foot and Ankle Conditions

Question 1

What is hallux valgus?

Answer 1

Lateral deviation of the big toe

Question 2

Hallux valgus is commoner in males. True/False?

Answer 2

False

Females 4:1 males

Question 3

What is a bunion?

Answer 3

Inflamed bursa over the 1st metatarsal head

Question 4

List conservative treatment for hallux valgus

Answer 4

Wearing more accommodating shoes

Spacers between 1st webspace

Question 5

Surgery for cosmesis in hallux valgus is really effective and patients are usually super happy. True/False?

Answer 5

False

Quite the contrary.

Question 6

What is hallux rigidus?

Answer 6

OA of the 1st metatarso-phalangeal joint

Question 7

What is the gold standard surgical treatment for hallux rigidus?

Answer 7

Arthrodesis - alleviates pain but reduced motion

Question 8

Arthrodesis prevents women wearing high-heels. True/False?

Answer 8

True

Question 9

What is Morton’s neuroma?

Answer 9

Irritation of plantar interdigital nerves, causing inflammation and swelling (neuroma)

Question 10

List clinical features of Morton’s neuroma

Answer 10

Pain/tingling radiating within toes

Loss of sensation in webspace

Question 11

What is a Mulder’s +ve click test for Morton’s neuroma?

Answer 11

Compression of metatarsal heads causes symptoms/clicking

Question 12

Women are more affected by Morton’s neuroma - what is a significant implicated cause of this?

Answer 12

High-heels

Question 13

Where do metatarsal stress fractures usually occur?

Answer 13

2nd-3rd metatarsal

Question 14

List aetiology for Achilles tendonitis

Answer 14

Repetitive strain (sports)
Quinolone antibiotics
Rheumatoid arthritis
Gout

Question 15

Steroid injections are contraindicated at the Achilles tendon. True/False?

Answer 15

True

Question 16

What clinical test is used to define tendon rupture?

Answer 16

Simmonds test (no plantarflexion of foot when calf is squeezed)

Question 17

List proposed causative factors for plantar fasciitis

Answer 17

Diabetes
Obesity
Walking on hard floors
Poor cushioning in shoes

Question 18

Where does the tibialis posterior tendon predominately insert?

Answer 18

Navicular bone

Question 19

What is pes cavus?

Answer 19

Abnormal high arch of the foot

Question 20

Describe claw toes

Answer 20

Hyperextension at MTPJ

Hyperflexion at PIPJ + DIPJ

Question 21

Describe hammer toes

Answer 21

Hyperextension at DIPJ + MTPJ

Hyperflexion at PIPJ

Question 22

Describe mallet toes

Answer 22

Hyperflexion at DIPJ

Question 23

What is the most common cause of acquired pes planus in adults?

Answer 23

Tibialis posterior dysfunction

Question 24

What is a fairly specific finding in tibialis posterior dysfunction?

Answer 24

Pain and swelling posterior to medial malleolus