ankles + feet Flashcards
what cells produce collagen for tendons
fibroblasts
RF achilles tendonitis
quinolones eg cipro // hypercholestraemia // sport injuries
symptoms achilles tendonitis
morning pain + stiffness // posterior heel pain worse after activity
mx achilles tendonitis
supportive, analgesia, boots
mechanism achilles tendon rupture
sudden deceleration
symptoms achilles tendon rupture
pop in ankle, sudden ankle pain, cannot walk
what triad o/e is used for achilles rupture
simmonds: lie prone: look for dorsiflexion, look for gap in tendon, squeeze calf muscle nothing happens
invx achilles rupture
USS
where does tibilias posterior tendon attach
medial malleolus to navicular tuberosity (medial heel)
what can causes tibilias posterior tendon dysfunction
obesity, diabetes, HTN, steroids, RA
symptoms tibilias posterior tendon dysfunction
pain and swelling medial malleous, harder to walk, midfoot and ankle pain
mx tibilias posterior tendon dysfunction
splint + physio, surgical decompression
what should be avoided in tendonopathies + why
steroids injections –> rupture
what causes plantar fasciitis
repeated stress
symptoms plantar fasciitis
pain in back of sole of heel, worse on exercise, positive tinel test
RF plantar fasciitis
diabetes, obese, over exercise
mx plantar fasciitis
gel pad shoes, analgesia, rest
symptoms hallux valgus (bunion)
lateral deviation of 1st metatarsal // medial bursitis (bunion) // ulcer // override 2nd toe
mx hallux valgus
wear wider shoes // surgery if causing functional issues
what is hallux rigidus
OA of first MTPJ
mx hallux rigidus
conservative, arthrodesis (fuse joint together)
what is morton’s neuroma
nerves over ligament become swollen after repeated trauma
where do moton’s neuroma usually occur
inbetween 3rd and 4th toe
who usually gets mortons neuroma
women who wear high heels
symptoms mortons neuroma
pain + burning in affected toe, loss of sensation in web space, mudlers click
invx + mx mortons neuroma
USS, insole, steroid injection, excision
where are metatarsal stress fractures likely to occur
2nd and 3rd metatarsal
what type of fracture are stress fractures
hairline
mx stress fracture
immobilisation boots if identified early
what is pes cavus
high arch
RF pes cavus
neurpathy, cerebral palsy, polio, spina bifida
RF flat foor
tibilais posterior dysfunction, RA, diabetes
what is charcot foot
sensory loss –> very damaged joints
causes charcot foot
diabetes, syphilis
symptoms charcot
swollen red joint, some degree of pain
invx charcot
xray –> bag of bones
which bones are involved in the ankle joint
tibia, fibula, talus
what is the syndesmosis of the ankle
binds distal tibia and fibula together (AITFL, PITFL, IOL, interossus)
what do the lateral collateral ligaments of the ankle do
attack distal dibular to the talus and the tallus + calcanus (heel bone)
what does the deltoid ligament of the ankle do
secure distal tibia to talus
what ligaments are involbed in low ankle sprain
collateral
cause + symptoms low ankle sprain
inversion // pain, bruising, swelling, tender, can usually weight bear
invx ankle sprain
xray according to ottowa rules // MRI if persistent
mechanism + symptoms high ankle sprain
v rare // external rotation // painful weight bearing // pain when tibia and fibula pushde togetehr
invx high ankle sprain
xray // MRI if worries
mx low ankle sprain
ICE // cast
mx high ankle sprain
cast // surgery
ottawa rules for Xray ankle
malleolar pain + one of: cannot weight bear 4 steps // tender medial or lateral distal tibia // bone tenderness distal tibia
