Ankle: Ligament Pathology 3

Question 1

Ankle impingement: usually occur secondary to

Answer 1

Trauma

Question 2

Ankle impingement: Pain located where?

Answer 2

• sinus tarsi
• syndesmosis
• posterior ankle
• anterolateral gutter

Question 3

Ankle impingement: usually occur due to

Answer 3

• hypermobility

- disruption of stabilizing structures

Question 4

Ankle impingement: Disruption of stabilizing structures…

Answer 4

• bones
• joint capsules
• ligaments
• tendons

Question 5

Ankle impingement: Recurrent ankle pain with (motions)

Answer 5

Either DF or PF

Question 6

Osseous impingement: what is it?

Answer 6

Abnormal calcification within the joint

Question 7

Osseous impingement: abnormal calcification within the joint, specifically where?

Answer 7

• talus
• tibia
• fibula

Question 8

Osseous impingement: May be the direct result of

Answer 8

• Anterior ankle capsule traction with repetitive minor trauma
• results from PF during activity

Question 9

Osseous impingement: Once the spur forms, DF may cause what?

Answer 9

• entrapment of bordering soft tissue
• contact with opposing bony structures
• causes chronic pain during activity

Question 10

Posterior impingement: occurs when?

Answer 10

Talus and/or neighboring soft tissue become compressed between the tibia and calcaneus with repetitive or extreme PF

Question 11

Posterior impingement: What may initiate posterior impingement?

Answer 11

• acute inversion ankle injuries

- overuse injuries involving trauma in ankle PF

Question 12

Heel pain: posterior heel pain differential dx

Answer 12

• retrocalcaneal bursitis
• haglund’s deformity
• Achilles tendinopathyh
• S1 radiculopathy
• Sever’s disease

Question 13

Heel pain: What is Sever’s disease?

Answer 13

Abnormal stress at the epiphysis

Question 14

Heel pain: Plantar heel pain differential dx

Answer 14

• plantar fascia microtrauma
• tibial nerve entrapment
• fat pad atrophy
• heel spur
• stress fx
• TTS
• subtalar hypomobility
• systemic problems
• S1 radiculopathy

Question 15

Heel pain: Systemic issues that may cause plantar heel pain

Answer 15

• Reiter’s syndrome
• gout
• RA

Question 16

Plantar fasciitis: what tissue may be affected?

Answer 16

• plantar fascia
• plantar ligament
• bone spur
• adverse nerve tension

Question 17

Plantar fasciitis: potential causes

Answer 17

• recent weight gain
• recent change in activity
• overuse
• dec GSC flexibility

Question 18

Plantar fasciitis: Pain most often where

Answer 18

At attachment of central slip

Question 19

Plantar fasciitis: Onset

Answer 19

Insidious

Question 20

Plantar fasciitis: Pain worse after period of

Answer 20

NWB

Question 21

Plantar fasciitis: Pain gradually improves at first with activity but worsens after

Answer 21

Prolonged activity

Question 22

Plantar fasciitis: Pain with (toe motion)

Answer 22

DF of 1st MTP

Question 23

Plantar fasciitis: Sharp pain with palpation, (does/does not) refer/travel

Answer 23

Does not

Question 24

Plantar fasciitis: Strong association with

Answer 24

BMI in nonathletic population

Question 25

Plantar fasciitis: risk factors | Weak association with

Answer 25

- increased age - decreased ankle DF - decreased 1st MTP extension - prolonged standing

Question 26

Plantar fasciitis: risk factors | Inconclusive

Answer 26

- static foot posture | - dynamic foot motion

Question 27

Plantar fasciitis: Risk factors | No association with

Answer 27

- height in nonathletic population | - height, weight, and BMI in athletic population

Question 28

Plantar fasciitis: Commonly accompanies strength deficits where?

Answer 28

Intrinsic and extrinsics

Question 29

Plantar fasciitis: In nonathletes, the pain is often from irritation of

Answer 29

Medial calcaneal nerve

Question 30

Plantar fasciitis: In nonathletes, the pain is often from irritation of the medial calcaneal nerve. Palpation at the nerve should be (better/worse) than palpation of MCT

Answer 30

Worse

Question 31

Plantar fasciitis: In nonathletes, the pain is often from irritation of the medial calcaneal nerve. Palpation of the nerve often worse with what special testing positions

Answer 31

SLR | Slump

Question 32

Plantar fasciitis: for treatment, focus on

Answer 32

- foot intrinsic - foot extrinsic - LQ biomechanics

Question 33

Plantar heel pain: (%) will report improvement in symptoms within 1 year

Answer 33

80%

Question 34

Plantar heel pain: Evidence for use of dexamethasone or acetic acid through iontophoresis in the short term

Answer 34

Moderate evidence

Question 35

Plantar heel pain: Moderate evidence that ionto should be used how long for pain relief and improved function

Answer 35

Short term 2-4 weeks

Question 36

Plantar heel pain: Evidence Calf muscle and/or PF specific stretching can be used to provide short term pain relief and improvement in calf flexibility

Answer 36

Moderate

Question 37

Plantar heel pain: Calf stretching | Moderate evidence to use for short term (how long) pain relief and improvement in flexibility

Answer 37

2-4 mos

Question 38

Plantar heel pain: Evidence | Calcaneal low dye taping

Answer 38

Weak

Question 39

Plantar heel pain: Weak evidence for calcaneal low dye taping to provide (short/long) term relief

Answer 39

Short term 7-10 days

Question 40

Plantar heel pain: Evidence | Prefabricated or custom foot orthoses

Answer 40

Strong

Question 41

Plantar heel pain: Strong evidence to support use of prefabricated or custom foot orthoses for (short/long) term relief

Answer 41

Short term - 3 mos

Question 42

Plantar heel pain: evidence | Use of prefabricated or custom foot orthoses for long term > 1 year management

Answer 42

NO evidence to support