8: Ankle and foot

Question 1

What is pes planus?

Answer 1

Flat foot

Question 2

What is pes cavus?

Answer 2

High arched foot

Question 3

What is the medical name for bunions?

Answer 3

Hallux valgus

Question 4

What surface of the foot can become inflamed?

What is this condition called?

Answer 4

Plantar surface

Plantar fasciitis

Question 5

Which strong tendon can become diseased?

Answer 5

Achilles tendon

Question 6

When assessing a patient’s gait, you should look from where?

Answer 6

In front

The sides

Question 7

Is pes planus normal?

Answer 7

Yes, 20% of people have it

Question 8

The feet get (flatter / more concave) and (broader / thinner) with time.

Answer 8

flatter

broader

Question 9

What is a common cause of pes planus?

Answer 9

Hypermobility

Question 10

When flat, the heel is ___. When you go on your tip toes, it goes ___.

(varus, valgus)

Answer 10

valgus

varus

Question 11

What is the main cause of acquired pes planus?

Answer 11

Tibialis posterior dysfunction

Question 12

What do people with tibialis posterior dysfunction complain of?

Answer 12

Pain posterior to medial malleolus

Difficulty walking

Question 13

How is acquired pes planus treated?

Answer 13

Physiotherapy

Question 14

Most people with tibialis posterior dysfunction are (male / female) and ___.

Answer 14

female

overweight

Question 15

What happens to the foot over time in people with tibialis posterior dysfunction?

Answer 15

Change in shape

Question 16

What other foot condition can be exacerbated by tibialis posterior dysfunction?

Answer 16

Hallux valgus

Question 17

If foot/ankle joints are arthritic in late stage TPD, how can they be treated?

Answer 17

Fusion

Stabilisation

Question 18

What is pes cavus?

Answer 18

High arched feet

Question 19

Most cases of pes cavus are idiopathic - what are some neurological causes?

Answer 19

Spina bifida

Stroke

Cerebral palsy

Polio …

Question 20

What spinal pathology, causing nerve root compression, may be implicated in patients with pes cavus?

Answer 20

Spinal tumours

Question 21

Where is the pain of plantar fasciitis felt?

Answer 21

Sole of the foot

Achilles tendon

Heel

Question 22

What are some causes of plantar fasciitis?

Answer 22

Physical overload - overexercise, obesity

Seronegative arthritis

Poorly fitting footwear

Question 23

How is plantar fasciitis treated?

Answer 23

NSAIDs

Orthotics

Physiotherapy

Rarely steroid injections

Question 24

What is the average duration of plantar fasciitis?

Answer 24

18 - 24 months

Question 25

What is hallux valgus?

Answer 25

**Bunions** swelling of tissue medial to hallux, causing it to go lateral (valgus)

Question 26

Who tends to get bunions?

Answer 26

**Teenage girls**, incidence increases with age

Question 27

How is hallux valgus managed?

Answer 27

**Supportive, rarely surgery**

Question 28

Where is bunion pain felt?

Answer 28

**Inside of the foot**

Question 29

What is hallux rigidus?

Answer 29

**Stiff, painful 1st MTPJ due to OA**

Question 30

Where is hallux rigidus pain felt?

Answer 30

**Top of the hallux**

Question 31

If it does not occur naturally within 2 years, how is hallux rigidus treated?

Answer 31

**Fusion of joint**

Question 32

What is the driving process behind joint damage in RA?

Answer 32

**Synovitis (capsular inflammation)**

Question 33

What do rheumatoid feet look like?

Answer 33

**Bunion - painful, swollen** **Bunion overcrowds toes, PIP joints dislocate**

Question 34

Is severe rheumatoid foot a common presentation nowadays?

Answer 34

**No, disease isn't given opportunity to progress that far**

Question 35

What's is Morton's neuroma?

Answer 35

**Fibrosis of digital nerve supplying toes (usually 3rd / 4th) due to compression**

Question 36

What is the main symptom of Morton's neuroma?

Answer 36

**Burning, tingly pain in toes** Neurogenic pain