Ankle and Foot Flashcards
What is Hallux valgus?
Bunions- deformity of great toe due to medial deviation of the 1st metatarsal and lateral deviation of the toe itself- poorly understood aetiology.
Treatment of Hallux Valgus?
Conservative treatment: wearing of wider and deeper shoes, use of space in the first web space
Loads of surgical options but none fully or always successful
What is Hallux Rigidus?
OA of the first MTPJ
What is Morton’s Neuroma?
Plantar interdigital nerves can become inflamed and swollen forming a neuroma due to repetitive trauma
What do patients with Morton’s neuroma complain of?
Burning pain and tingling
Exam of Mortons neuroma? Tests?
Loss of sensation in affected nerve space. Medic-Lateral compression of the metatarsal heads (exerted by squeezing forefoot with your hand) may reproduce symptoms or click (Mulders). USS shows swollen nerve.
Metatarsal stress fractures are most commonly…
in 2nd MT followed by 3rd
Patient with metatarsal stress fracture will complain of… why may it be difficult to diagnose?
Sudden, severe weight bearing pain. X-rays normal at first so need MRI or bone scan
Causes of Metatarsal stress fractures?
Soldiers (prolonged marching), runners, unaccustomed walking, new shoes
What can cause achilles tendonitis?
Repetitive strain from sports or due to degenerative process
Treatment of achilles tendonitis?
Rest, physio, use of a heel raise to off load tendon and boot or splint
Tendonitis predispose to …
tendon rupture
In achilles tendonitis what should not be administered?
Steroid injections- this could cause rupture!!
What will patient complain of in Achilles tendon rupture?
Sudden pain in the back of the leg and difficulty weight bearing.
Examination of achilles tendon rupture?
Weakness of plantar flexion and a palpable gap in the tendon usually apparent
What is plantar fasciitis?
Self limiting receptive stress/ overload or degenerative condition of the foot which causes inflammation of the plantar aponeurosis of the foot.
Things that are thought to contribute to plantar fasciitis?
Diabetes, obesity, and frequent walking on hard floors with no cushioning as well as degeneration with age.
Treatment of plantar fasciitis?
Rest, achilles and plantar fascia stretching may help. Steroid injections may help. Symptoms cantata up to 2 yrs to resolve. There are some surgeries but these are controversial.
Where is the tibias posterior tendon and what does it do?
Inserts predominantly onto the medial navicular to serve the medial arch.
Describe tibialis posterior tendon dysfunction
The tendon is under repeated stress and with degeneration can develop tendonitis, elongation and eventually rupture.
Will complain of pain and or swelling posterior to the medial malleolus, change in foot shape and diminished walking ability.
Treat: physio, insoles, orthoses, bespoke footwear and surgery.
What is pes cavus? What causes it?
high arch of the foot
commonest is idiopathic but can be related to NM conditions
What causes claw and hammer toes?
Occur due to acquired imbalance between flexor and extensor mechanism
