Common foot problems

Question 1

what is plantar fascitis?

Answer 1

inflammation of the plantar fascia - a thick connective tissue which attaches to the calcaenus at the heel and travels along the sole of the foot and branches out to connect to the flexor tendons at the toes.

Question 2

how does plantar fascitis present?

Answer 2

gradual onset of pain on the plantar aspect of the heel
worse with pressure
worse when walking / standing for prolonged periods
tenderness on palpation

Question 3

management of plantar fascitis

Answer 3

rest, ice, analgesia (NSAIDs), physiotherapy
steroid injections !can cause rupture of the plantar fascia or fat pad atrophy.

extracorporeal shockwave therapy
surgery

Question 4

what is fat pad atrophy?

Answer 4

atrophy (wasting away) of the fat pad over the heel of the foot. due to inflammation from repetitive impacts (jumping, running, walking, obesity).

Question 5

presentation of fat pad atrophy

Answer 5

pain and tenderness over the plantar aspect of the heel
symptoms are worse with activities (bare foot / hard surfaces)

Question 6

investigation of fat pad atrophy

Answer 6

measure thickness of the fat pad with ultrasound scan

Question 7

management of fat pad atrophy

Answer 7

comfy shoes
custom insoles
adapting activities
weight loss

Question 8

bunions ‘hallux valgus’

Answer 8

a bony lump created by a deformity at the MTP at the base of the big toe. the first metatarsal bone becomes angled medially and the big toe becomes angled laterally. the MTP joint becomes inflamed and enlarged.

painful

slow to develop
cause unclear

Question 9

bunion investigations

Answer 9

Weight-bearing x-rays can be used to assess the extent of the deformity.

Question 10

bunions management

Answer 10

Conservative management is with wide, comfortable shoes and analgesia. Patients can use bunion pads to protect the bunion from friction inside their shoes.