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MSK 2020 > Adult Foot and Ankle Problems > Flashcards

Adult Foot and Ankle Problems Flashcards

1
Q

another name for hallux valgus

A

bunion

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2
Q

what is hallux valgus?

A

there is medial deviation of the 1st metatarsal and lateral deviation of the toe with a bony lump appearing on the medial side

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3
Q

risk factors for hallux valgus

A 
FH
age
shoes
RA
neuromuscular diseases e.g. cerebral palsy
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4
Q

presentation of hallux valgus

A

pain and skin breakdown due to rubbing on shoe leading to inflamed bursa
usually bilateral

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5
Q

management of hallux valgus

A

shoes
use of spacer to prevent rubbing of toes and impingement
surgery for cosmetic reasons

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6
Q

surgery options for hallux valgus (most dissatisfied)

A

Scarf/Akin osteotomy

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7
Q

what is hallux rigidus?

A

first MTPJ OA

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8
Q

what causes hallux rigidus?

A

degeneration

or secondary to injury

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9
Q

management of hallux rigidus

A

stiff soled shoes to limit motion
removal of osteophytes
arthrodesis (GOLD STANDARD)
joint replacement

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10
Q

what is primus varus?

A

first metatarsal bone is angled away from the second

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11
Q

what is morton’s neuroma?

A

plantar interdigital nerve is subject to repeated trauma leading to inflammation, swelling and fibrosis forming a neuroma

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12
Q

presentation of morton’s neuroma

A

metatarsalgia (inflamed ball of foot)

burning can radiate to affected toe

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13
Q

diagnosis of morton’s neuroma

A

loss of sensation in affected web space (often 2nd or 3rd)
Mulder’s click test (compression of metatarsal head)
USS of swollen nerve

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14
Q

management of morton’s neuroma

A

pad/insole
steroids and anaesthetic injections
surgical excision (small risk of reoccurrence)

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15
Q

what causes Achilles tendonitis?

A

repetitive strain

OR degeneration

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16
Q

risk factors for achilles tendonitis

A

quinolone antibiotics
RA
inflammatory arthropathies
gout

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17
Q

presentation of achilles tendonitis

A

pain
morning stiffness
eases with heat/walking

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18
Q

management of achilles tendonitis

A 
rest
physiotherapy
heel raise to offload tendon
orthotic splint
boot
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19
Q

what does achilles tendonitis predispose to?

A

rupture

20
Q

what should you never use with a tendon injury?

A

steroid injections

21
Q

what causes achilles tendon rupture?

A

sudden deceleration with resisted calf muscle contraction

22
Q

presentation of achilles tendon rupture

A

pain
difficulty bearing weight
palpable gap

23
Q

diagnosis of achilles tendon rupture

A

Simmond’s test

24
Q

what is a positive Simmond’s test result?

A

no plantarflexion of foot when squeezing calf

25
Q

management of achilles tendon rupture

A

surgery

casting in equinous position

26
Q

what is an ankle sprain?

A

injury to ligaments in the foot caused by twisting forces

27
Q

classification of ankle sprain

A

Graded 1-3 OR Weber’s classification

28
Q

presentation of ankle sprain

A

pain
bruising
tenderness

29
Q

what is Ottowa’s XR criteria?

A

criteria used to decide whether foot and ankle injuries need an XR

30
Q

management of ankle sprain

A

RICE

physiotherapy

31
Q

what is plantar fasciitis?

A

this is repetitive stress/overload/ degeneration to fascia on the sole of the foot

32
Q

risk factors for plantar fasciits

A

obesity
DM
frequent walking
age (fat pad atrophies)

33
Q

presentation of plantar fasciitis

A

start-up pain after rest
pain after exercise
swelling of plantar medial aspect of heel with tenderness

34
Q

management of plantar fasciitis

A 
NSAIDs and rest
gel filled heel pad
night splint
stretching/physio
steroid injections
35
Q

how long does it take plantar fasciitis to resolve?

A

2 years

36
Q

what does the tibialis posterior tendon support?

A

medial arch and plantar flexion of the foot

37
Q

what is a common cause of tibialis posterior tendon dysfunction?

A

pes planus (flat feet)

38
Q

presentation of tibialis posterior tendon dysfunction

A

pain
swelling posterior to medial malleolus
diminished walking ability/balance
dislike of uneven surfaces

39
Q

management of tibialis posterior tendon dysfunction

A 
physio
insoles
footwear
splinting
surgical decompression and tendon transfer
40
Q

can claw and hammer toes happen in fingers too?

A

yes

41
Q

what is a claw toe

A

hyperextension of MTPJ with hyperflexion at PIPJ and DIPJ

42
Q

what is a hammer toe?

A

hyperextension at DIPJ

43
Q

what is a mallet toe?

A

resisted extension

44
Q

presentation of abnormal toes

A

pain

skin breakdown due to rubbing

45
Q

management of abnormal toes

A

toe sleeves and plasters
tendon surgery
arthrodesis
amputation

MSK 2020 (35 decks)

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