Ankle & Foot

Question 1

What condition is likely the cause of these findings?

Answer 1

• Non-uniform loss of joint space at first metatarsal-phalangeal joint
• Subchondral sclerosis
• Osteophytes at base of phalange

→ DJD → OA of that joint

Referred to as Hallux Rigidus

Question 2

What condition is likely the cause of these findings?

Answer 2

DX: RA

Periarticular osteopenia at 2nd-5th metatarsal-phalangeal joints & proximal interphalangeal joints

Question 3

___ likes to affect the metatarsal phalgeal joints

Answer 3

RA

Question 4

Fibular deviation at metatarsal-phalangeal joints is called ____ & associated with ____

Answer 4

Lanois Deformity

RA

Question 5

What condition is likely the cause of these findings?

Answer 5

• Severe decreased bone density
• Pencil thin cortices
• Complete loss of joint space with extensive subchondral destruction at metatarsal phalangeal joints
• “Pencil in cup” appearence seen at 5th metatarsal phalangeal joint
• Osseous ankylosis of PIPS & DIPS

DX: Inflammatory Arthritis → Psoriatic Arthritis or Reactive Arthritis

Question 6

Involvement of DIPS of feet/hand has what 4 DDX

Answer 6

Psoriatic

Reactive

OA

Gout

Question 7

What condition is likely the cause of these findings?

Answer 7

Question 8

What condition is likely the cause of these findings?

Answer 8

• Large soft tissue mass with calcifications at 1st metatarsal
• Overhanging margin sign at 5th metatarsal

DX: Gout

Question 9

What is the name of the joint affected here?

Answer 9

Choparts Joint

Question 10

What condition is likely the cause of these findings?

Answer 10

Gout w/ overhanding margin

Question 11

What condition is likely the cause of these findings?

Answer 11

• Complete loss of joint space
• Increased density at Choparts joint
• Aggressive Destructive arthritis →

DDX: Neuropathic arthopathy or Septic Arthritis

Question 12

What are the bone destruction patterns associated with Neuropathic Arthropathy

Answer 12

Hypertrophic

Atrophic

Mixed

Question 13

The 6 D’s of hypertrophic pattern associated with Neuropathic Arthropathy =

Answer 13

Dense bone (sclerosis)

Debris or loose bodies

Destruction

Disorganization of joint

Dislocation

Distension of joint

Question 14

What condition is likely the cause of these findings?

Answer 14

Question 15

• Rupture of AITFL (Ant. Inf. Tibiofibular Lig)
• Causes widening of tibiofibular space

= Stage ____ SER injury

Answer 15

1

Question 16

Spiral fracture of fibular malleolus = Stage ____ of SER injury

Answer 16

2

Question 17

Rupture of PITFL or fracture of posterior malleolus of tibia in addition to AITFL rupture & fibular spiral fracture = Stage ____ of SER injury

Answer 17

3

Question 18

Fracture through the medial mlleolus or disruption of deltoid ligament in addition to rupture of AITFL & PITFL rupture = Stage ____ of SER injury

Answer 18

4

Question 19

Adduction of the talus compresses the medial malleolus and stretches the lateral ankle structures →

Transverse fracture of the lateral malleolus at or below the level of the plafond, with rupture of the ATFL or tearing of the calcaneofibular ligament

= SAD Stage ____

Answer 19

1

Question 20

Vertical oriented fracture at medial malleolus =

Answer 20

SAD Stage 2