ankle and foot

Question 1

achilles tendon injuries

Answer 1

tendinitis= overuse/ damage to achilles
non instertional–> small tears in middle fibers of tendon start to break it down
insertional–> occurs when tendon meets bone
younger adults
risks- poor posture, presence of muscle weakening diseases, certain medication (statins)/ active people
symptoms- pain down back of leg and heel. tendon is thick/ hard, inflamed, swollen and irritated. causes pain and swelling/ bony spur

rupture= complete/ partial break in tendon. caused by increased sports ppt, falling from a height, stepping into a hole
any age
risks- wearing wrong shoes when exercising, bone spurs on ankle, exercising on an uneven surface
symptoms- stiff/ sore achilles in morning, pain worse when active, difficulty flexing foot
prognosis- Can be treated with rest and anti-inflammatory drugs. Exercise can help. May need surgery

Question 2

ankle sprains

Answer 2

=stretched/ teared ligaments
caused by a fall, landing awkwardly on foot, walking/ exercising on uneven surface, someone stepping on your foot
anyone at risk but females over 30 are more susceptible
risks- athlete, prior ankle injury, poor physical condition, improper shoes
symptoms- pain when weight bearing, tenderness when touched, swelling, bruising, restricted ROM, instability, popping sensation
prognosis- usualy treated in 2-12 weeks with RICE

Question 3

retrocalcaneal bursitis

Answer 3

=inflammation of bursa around heel
caused by overtraining in an athlete, tight/ poorly fitted shoes, altered joint axis
over 65YOA
risks- athletes, people wearing heels, gout, RA
symptoms- pain at back of heel, pain getting worse when rising on toes, tenderness at back of heel, swelling at back of heel, increase in pain in activities loading calf
prognosis- go away with treatment

Question 4

bunion/ hallux valgus

Answer 4

=foot deformity in first metatarsophalangeal joint
may be congenital (boren with them)juvenile or adolescent (between 10-15YOA) or tailor’s (forms on 5t metatarsal due to pressure from foot mechanics)
20-44/ 65+
risks- women, tight/ high heeled shoes, congenital deformity, chronic achilles tightness, severe flatfoot, hypermobility in 1st metatarsocuneiform joint
symptoms- distal end of 1st metatarsal drifts medially and the proximal phalanx deviates laterally, inability to bend big toe/ pain when attempting, difficulty wearing regular shoes, thickened skin
prognosis- doesn’t go away, treatment focuses on relieving symptoms. bunion pads/ taping, footwear changes, NSAIDs, physical therapy

Question 5

plantar fascitis

Answer 5

=inflammation of plantar fascia
caused by tension/ stress on fascia irritating and tearing fascia
40-60YOA
risks- runners, overweight people, foot mechanics e.g. flatfeet/ high arch, daily activities
symptoms- stabbing pain in the morning, triggered after long periods of standing
prognosis- good prognosis. most symptoms will be treated with rest, change of footwear, NSAIDs, corticosteroid injections and physical treatment

Question 6

gout

Answer 6

=form of arthritis
caused by urate crystals accumulating in the joint that form when there’s a high level of uric acid in the blood (produced when body breaks down purines)
30-50YOA
risks- diet rich in red meat, shellfish and drinks with fructose in, alcohol consumption, overweight, certain medical diseases e.g. blood pressure and diabetes, certain medications, men
symptoms- sudden attacks of pain/ swelling, redness, tenderness in joints, feeling of big toe being on fire, limited ROM
prognosis- usually lasts 5-7 days. may not cause lasting damage to joints if treatment is done quickly. acute–> colchicine, NSAIDs, corticosteroids, RICE. long term–> urate-lowering therapy, treat-to-target strategy