Exam 2 - Foot pain

Question 1

What mnemonic can be helpful for the provider to determine the cause of foot pain? What does each letter stand for?

Answer 1

M: malformation

I: inflammation

N: neoplasm

T: trauma

Question 2

Examples of foot malformations

Answer 2

• Pes planus
• Metatarsus adductus

Question 3

Examples of foot inflammation

Answer 3

• Osteoarthritis
• Gout
• Plantar fascitis
• Achilles tendonitis
• Infection (e.g. ulcers, gangrene)

Question 4

Examples of neoplasms of the foot

Answer 4

• Plantar fibroma (benign)
• Warts
• Morton’s neuroma
• Corns
• Bunions

Question 5

Examples of trauma of the foot

Answer 5

• Fractures
• Sprain
• Strain
• Contusion
• Laceration

Question 6

What common complaint will patients come in with if they have plantar fascitis?

Answer 6

Heel pain

• Pain first thing in the morning with first steps

Question 7

What causes plantar fascitis?

Answer 7

Micro tear in plantar fascia

• Proximal insertion point of tendon will be where most of the pain is

Question 8

What test can be performed to assess for plantar fascitis?

Answer 8

Windlass test

Question 9

How would the provider perform the Windlass test?

Answer 9

• Stabilize big toe over proximal inner phalangeal
• Dorsiflex toe (push back)
• If plantar fascitis, will endorse pain

Question 10

Plantar fascitis treatment

Answer 10

Micro tear, so can treat like you would for sprain/strain

• Stretching, rolling ball on heel, taping near heel
• PT
• First line: NSAIDs to prevent inflammation

If patient has persistent pain (after morning), try night splints

• Corticosteroid injections at orthopedics referral