Diagnostic stuff

Question 1

Describe how you would perform a distal tibiofibular joint diagnosis

Answer 1

1. Patient supine
2. Flex knee to allow patient to plant heel on table surface
   • Stabilize the forefoot with your medial hand
3. Using a pincer grasp to the lateral malleolus assess:
   • Anterior Glide: apply an anterior motion
   • Posterior Glide: apply a posterior motion

Question 2

Describe how you would perform a tibiotalar joint diagnosis

Answer 2

Place your thumbs on the slow of the foot and dorsiflex the foot to feel the posterior glide

Do the same evaluation with the thumb resting on the top of the talus bone and dorsiflex.

Do the same thing with plantar flexion to test for an anterior glide

Question 3

In what motion does an anteromedial glide occur in?

Answer 3

Eversion

Question 4

In what motion does a posterior glide of the talus occur in?

Answer 4

Inversion

Question 5

What motion does an everted talocalcaneal favor?

Answer 5

eversion

Question 6

What motion does an inverted talocalcaneal favor?

Answer 6

Inversion

Question 7

What does the cuboid bone tend to prefer?

Answer 7

Eversion glide with plantar glide

Question 8

What does the navicular bone tend to favor?

Answer 8

Inversion glide with a plantar glide

Question 9

What does a cuneiform bone tend to favor?

Answer 9

Plantar glide only

Question 10

How do you differentiate a cuneiform diagnosis

Answer 10

Moving from medial to lateral diagnose and compare anterior and posterior glide in the 1st, 2nd & 3rd Cuneiform. Commonly, the somatic dysfunction present favors plantar glide. Dorsal glide somatic dysfunction is often associated with hypertonic plantar fascia.

Question 11

What are the 3 axes of motion in the metatarsophalangeal and interphalangeal joints?

Answer 11

Plantar and dorsal glide, medial and lateral glide, internal and external rotation

Question 12

Describe how you would diagnose an IR/ER tibiofemoral joint SD

Answer 12

• Patient: Seated, hip flexed 45° knees flexed to 90°
• Physician: Seated facing dysfunctional leg
1. Place hands around tibial plateau
2. Externally Rotate tibia to assess for restriction of motion
3. Internally Rotate tibia to assess for restriction of motion

Question 13

How would you diagnose a fibular head SD

Answer 13

• Patient: Seated or supine with hip flexed to 45°and knee flexed to 90°
– Modification: patient seated, legs hanging off table • Physician: Seated at end of table on side of
dysfunction, facing head of table
1. Grasp proximal fibular head between index finger and thumb
2. Translate anterior/posteriorly noting any ease and restriction of motion