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MSK wk 4 > adult foot and ankle disorders > Flashcards

adult foot and ankle disorders Flashcards

1
Q

What is pes planus?

A

flat feet

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2
Q

What is pes cavus?

A

high arched feet

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3
Q

The older we get the feet get flatter T/F

A

T

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4
Q

What is the most common cause of acquired flatfoot deformity in adults?

A

Tibialis posterior dysfunction

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5
Q

Where does the tibialis posterior tendon run

A

courses immediately posterior to medial malleolus

Attaches to navicular tuber sty and plantar aspect of medial and middle cuneiform

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6
Q

What is the function of the tibias posterior tendon?

A

primary dynamic stabiliser of medial longitudinal arch-elevates arch

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7
Q

What are RF for tibias posterior dysfunction?

A 
obese middle aged women
increase with age
flat foot
hypertension
diabetes
steroid injetion
seronegative antibodies
idiopathic tendonosis
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8
Q

What does Tibias posterior dysfunction look like?

A 
pain and/or swelling posterior to medial malleolus-very specific
change in foot shape
diminished walking ability/balance
mid foot and ankle pain
lateral wall "impingement" pain
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9
Q

What is the treatment for arthritic joints in foot?

A

fuse it

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10
Q

high arch, clawing taws, stiff, tight

A

think neurology esp if asymmetric, new and progressive

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11
Q

What is the treatment for TPD?

A

physio
insole to support medial longitudinal arch
orthoses to accommodate foot shape
NO steroid injecitons- the tendon will just rupture
surgery

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12
Q

Plantar fasciitis cause

A 
physical overload
seronegative arthropathy
diabeted
abnoraml foot shape
improper footwear
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13
Q

plantar fasciitis treatments

A 
NSAIDS
night splints
taping
heel cups or medial arch supports
physio
steroid injection
Surgery- only 50% success
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14
Q

Plantar fasciitis is self-limiting

A

True - lasts 18-24 months

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15
Q

What are the causes of pes cavus

A

idiopathic commonest

variety of other causes - HSMN,CP,Polio,Spina bifida, club foot

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16
Q

Bunion(Hallux valgus) background

A

familial background
but inappropriate footwear such as heel can make it worse
general joint laxity/CTDs

17
Q

What is plantar fasciitis?

A

fullness or swelling plantar medial aspect of heel
(tenderness over plantar aspect of heel and/or plantar medial aspect of heel)
Tinel’s test positive for Baxter’s nerve

18
Q

Incidence of hallux valgus

A

increases with age
usually bilateral
3F>1M
adolescent subgroup

19
Q

What is the pathogenesis of rheumatoid foot?

A

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

20
Q

What is Morton’s neuroma

A

degenerative fibrosis of digital nerve near its bifurcation

They get forefoot pain and burning and tinging in toes

21
Q

What is the management of Morton’s neuroma

A

Non -op (insoles, injections)

Operative (excise)

22
Q

What is tendon-achilles tendinosis?

A

Repetitive microtrauma,failure of collagen repair with loss of fibre alignment/structure
pain, morning stiffness, eases with heat/walking

23
Q

What is the management of tendon-achilles tendonosis?

A 
Activity modification/analgesia
NSAIDs
shockwave therapy
orthotics
physio
surgery
24
Q

Who does tend-achilles rupture occur in?

A

usually over 40s
often pre-existing tendinosis
sudden declaration with resisted calf contraction
patients often think somebody had hit them

25
Q

What does tend-achilles rupture look like clinically?

A

unable to bear weight
weak plantar flexion
palpable painful gap
positive calf squeeze (Simmonds) test

26
Q

What is Hammer toe?

A

PIP joint flexing

27
Q

What is curly toes?

A

The whole thing flexing

28
Q

What is claw toe?

A

a toe that is contracted at the PIP and DIP joints

29
Q

What is mallet toe?

A

joint at the end of the toe cannot straighten

30
Q

What is ankle sprain?

A

elastic limit of ligaments
longer to resolve than fracture
typically lateral ligaments
pain, bruising and tenderness

31
Q

What is the surgery of claw hammer and mallet toes?

A

tenotomies ( division of tendons), tendon transfer, fusions (PIP) or amputation

32
Q

What is the management of ankle sprain?

A

Non-operative

  • RICE
  • Physiotherpay- strength, stability,proprioception

Operative
-Brostrum Gould

33
Q

What is the Weber classification?

A

The commonest classification for ankle fractures
Weber a- fractures affecting just the tip of the lateral malleolus
Weber b- goes through the syndesmoses (communication between tibia and fibula)
Weber c-above the level of the ankle joint

MSK wk 4 (11 decks)

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