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MSK > Adult Foot and Ankle Disorders > Flashcards

Adult Foot and Ankle Disorders Flashcards

1
Q

What is the test to see how tight the gastrocneumius is?

A

Silverskiolds- dorsiflfexion with a straight leg and then with knee bent

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2
Q

What is the common name for pes planus?

A

flat feet

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3
Q

How can you tell flexible flat feet from inflexible?

A

flexible flat feet form an arch when the patient tip-toes

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4
Q

What is the most common cause of acquired flat feet in adults?

A

tibialis posterior dysfunction

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5
Q

What is the course of the tibialis posterior?

A

courses immediately posterior to medial malleolus and attaches on to the plantar aspect of medial and middle cuneiforms and navicular

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6
Q

What are the functions of tibialis posterior?

A

invertor; plantar-flexor; stabilises the medial longitudinal arch- elevates arch

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7
Q

Who is tibialis posterior dyfunction typically seen in ?

A

obese middle aged females (increases with age)

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8
Q

What are the conditions associated with tibialis posterior dysfunction?

A

hypertension; diabetes; seronegative arthropathies; tendinosis

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9
Q

What are the symtpons of tibialis posterior dysfunction?

A

pain and/or swelling posterior to medial malleolus; change in foot shape; diminshed walk ability/blanace and dislike of uneven surfaces; more noticeable hallux valgus; lateral wall “impingement” pain

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10
Q

What are the treatment options of tibialis posterior dysfunction?

A

PT; insoles to support medial longitudinal arch

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11
Q

What is pes cavus?

A

high arched feet

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12
Q

What are the causes of pes cavus?

A

mainly idiopathic but neurological- CP; polio; spina bifida

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13
Q

How does plantar fasciitis present?

A

start-up pain after rest:usually when wake-up; fullness or swelling and tenderness plantarmedial aspect of heel; sharp stabbing pain

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14
Q

What causes plantar fasciitis?

A

physical overload; seronegatvie arthropathy; diabetes; abonrmal foot shape; improper footwear

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15
Q

What are the treatments for plantar fasciitis?

A

NSAIDs; PT; heel cups or medial arch supports

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16
Q

What is the prognosis for plantar fasciitis?

A

usually self-limiting over 18-24 months

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17
Q

Why can hallux valgus be caused by flat feet?

A

if feet are always falling inwards, hallux tries to ocmpensate

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18
Q

Who gets hallux valgus?

A

increases ewith age; usually bilateral; females 3x more than males

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19
Q

What can cause hallux vlagus?

A

familial; shoes; general joint laxity; RA

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20
Q

What are the problems associated with hallux valgus?

A

transfer metersalgia;lesser toe impingement; pin; deformity; shoe difficulties

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21
Q

What is transfer metatarsalgia?

A

2nd toe has to take over main weight bearing and this causes pain

22
Q

What is the management for hallux valgus?

A

shoe modificatiosn, padding etc; operative-osteotomy

23
Q

What is hallux rigidus?

A

OA of 1st MTPJ

24
Q

What are the operative options for hallux rigidus?

A

joint replacement and fusion

25
Q

What is the pathogenesis of rheumatoid foot?

A

synovitis; proteinases and collagenases; impaired integrity of joint capsules/ligaments; destruction of hyaline cartilage

26
Q

What is morton’s neuroma?

A

degenerative fibrosis of digital nerve near its bifurcation

27
Q

What are the symptoms of mortons neuroma?

A

forefoot pain (metatarsalgia); burning and tingling in toes

28
Q

Who gets mortons neuroma/

A

45-50 years; F>M

29
Q

What occurs with tendo-achilles tendinosis?

A

repetitive microtrauma, failure of collagen repair with loss of fibre alignment/structure

30
Q

What are the symptoms of achilles tendinosis?

A

pain; morning stiffness, eases with heat/ walking

31
Q

What are implicated as causes for achilles tendinosis?

A

over-training, some drugs- ciprofloxacin, steroids;

32
Q

What are the treatment options for achilles tendinosis?

A

activity modifications/analgesia/ NSAIDs; shockwave therapy; orthotics; PT; surgery

33
Q

What is seen on presentation of an achilles rupture?

A

sudden decelration with resisted calf contraction; unable to weight bear; weak plantar flexion; palpable painful gap; positive calf squeeze- if foot fails to flex (simmonsds test)

34
Q

Who gets an achilles rupture?

A

usually over 40s; pre-existing tendinosis

35
Q

What causes claw, hammer and mallet toes?

A

an acquired imbalance between flexors and extensores

36
Q

What happens with claw toes?

A

hyperextension; flexion; flexion

37
Q

What happens with mallet toe?

A

flexion only at DIP

38
Q

What happens with hammer toe?

A

hyperextension; flexion; normal

39
Q

What is the management for claw, hammer and mallet toes?

A

surgery- tenonotomes tendon transger; fusion

40
Q

What type of trauma causes an ankle sprain?

A

twisting forces- commonly inversion or twisting forces on a planted foot

41
Q

What is the presentation of an ankle sprain?

A

pain; bruising and tenderness

42
Q

What happens with an ankle sprain?

A

the elastic limit of ligaments is reached which causes a tear

43
Q

What is the management for ankle sprains?

A

RICE- rest; ice; compression and elevation; PT

44
Q

What are the classifications for ankle fractures?

A

Webers- A- below syndesmoses
B- around syndesmoses
C- above the syndesmoses

45
Q

What is significant about Weber class C fractures?

A

unstable until proven otehrwise

46
Q

What is a stable ankle fracture?

A

a distal fibula fracture with no medial malleolus fracture or deltoid ligament rupture

47
Q

What causes an ankle fracture to be unstable?

A

medial malleolus fracture or deltoid ligament rupture, talar shift

48
Q

What is a Pilon fracture?

A

A fracture involving the distal end of the tibia at its articulation at the ankle joint

49
Q

What usually causes a 5th metatarsal fracture?

A

an inversion injury

50
Q

What is a Lisfranc fracture?

A

an injury where one or more of the metatarsals are dislocated from the tarsal bones

51
Q

What often causes a calcaneus fracture?

A

landing on heal when falling from a height

52
Q

What is it important to do with a calcaneus fracture?

A

check for other injuries

MSK (39 decks)

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