Ankle and Leg

Question 1

what are the two areas for which the ankle joint can be palpated?

Answer 1

medial to the anterior tibialis in the anteromedial recess, lateral to the peroneus tertius in the anterolateral recess

Question 2

resisted inversion with the foot plantarflexed and everted isolates muscle strength testing of what muscle?

Answer 2

tibialis posterior

Question 3

resisted ankle eversion tests the strength of what muscles

Answer 3

peroneals

Question 4

during the anterior drawer test of the ankle, you should rotate the talus in what way to detect true ankle instability, which is a rotary phenomenon?

Answer 4

internal rotation of the talus during the anterior drawer

Question 5

twisting injuries produce what pattern of fibula / tibia fracture?

Answer 5

spiral

Question 6

what is the percentage of weightbearing from the fibula and tibia, respectively?

Answer 6

fibula - 20%
tibia - 80%

Question 7

fibula shaft fractures can be associated with injury to what ligamentous structure?

Answer 7

syndesmosis

Question 8

t/f a majority of fibular shaft fractures are treated non surgically

Answer 8

true

Question 9

the common peroneal nerve traverses at the level of what portion of the fibula?

Answer 9

proximal fibular neck

Question 10

a high fibula fracture with syndesmosis injury is usually associated with injury to what other area of the lower leg?

Answer 10

medial malleolus fracture or deltoid ligament rupture

Question 11

t/f syndesmotic injury or disruption of the ankle mortise associated with ankle fracture require surgical repair

Answer 11

true

Question 12

what is the pathophysiology of MTSS?

Answer 12

periostitis by traction from posterior lower leg muscles

Question 13

a runner presents with bilateral shin pain. you are trying to differentiate MTSS from BSI. The MRI shows longitudinal edema of the periosteum. what is the diagnosis?

Answer 13

MTSS

Question 14

what is the first line treatment for CECS?

Answer 14

activity modification

Question 15

why is the region of the achilles tendon 6cm proximal to insertion in the calcaneus most prone to rupture?

Answer 15

relatively hypovascular area of tendon

Question 16

what peripheral nerve can be injured during an achilles tendon repair?

Answer 16

sural nerve

Question 17

in what general ankle position should immobilization occur if pursuing non operative management of achilles tendon rupture?

Answer 17

plantarflexion with progressively increased dorsiflexion during recovery/rehab

Question 18

which area of the posterior tibialis tendon is the most hypovascular and most susceptible to injury?

Answer 18

area below and behind the medial malleolus

Question 19

t/f steroid injections are considered a viable option for posterior tibialis tendinitis

Answer 19

false - this can lead to rupture of the tendon and should be avoided

Question 20

describe the single heel raise test for posterior tibialis tendinopathy/ dysfunction ?

Answer 20

single leg heel raise should result in varus alignment, heel will remain valgus during heel lift in PTT dysfunction

Question 21

which posterior ankle tendon is situated between the medial and lateral posterior tubercles of the talus?

Answer 21

FHL tendon

Question 22

os trigonum can predispose to injury of what flexor tendon of the foot/ankle?

Answer 22

FHL tendon

Question 23

a patient has pain with palpation in the retromalleolar region of the lateral ankle with pain upon resisted eversion. what is the most likely diagnosis?

Answer 23

peroneal tendon pathology

Question 24

lateral talar osteochondral lesions are typically associated with what mechanism of injury?

Answer 24

inversion

Question 25

t/f osteochondral autograft transplantation is an option for larger osteochondral lesions of the talus that have failed previous surgical treatment

Answer 25

true

Question 26

which structure forms a labrum like structure at the posterior tibial plafond and can cause posterior ankle impingement if torn?

Answer 26

posterior tibiofibular ligament

Question 27

test for posterior ankle impingement by moving the ankle into what position?

Answer 27

plantarflexion