Feet Flashcards
What bones to palpate during exam?
- Base of 5th metatarsal
- navicular tuberosity
- head of talus
- metatarsal heads
- lateral and medial malleolus
What ligaments to palpate during exam?
- calcaneofibular ligament
- ATFL
- superficial deltoid ligament
- spring ligament
- plantar fascia
- spring ligament
Special tests of foot?
- Thompson’s test
- Abduction stress test
- Calcaneal compression test
What is Thompson’s test?
pt prone, leg extended, squeeze calf and if foot doesnt plantar then its positive
What is calcaneal compression test (squeeze test)?
squeeze posterior heel, if pain, then suggestive of stress fracture (calcaneal apophysitis)
Ddx of plantar fasciitis?
Neuropathies: tarsal tunnel
Skeletal: fracture, stress fracture, arthritis
Soft tissue: posterior tibial tendonitis, retrocalcaneal bursitis
Treatment for plantar fasciitis?
- Stretching, ice massage, NSAIDs/APAP, heel cups/OTC orthotics
- Physical therapy: eccentric stretches, iontophoresis, myofascial massage
- Prescription custom arch supports
- Night splint
Last ditch treatments for plantar fasciitis?
Botox, extracorporeal shock wave therapy, plantar fasciotomy
Treatment of turf toe?
Initial: NSAIDs, walking boot with toe separator/toe plate, be careful with taping
Grade II and III injuries may take up to 8wks to recover with immobilization
Refer: instability weeks out despite above
What is a Jones fracture?
stress fracture of base 5th metatarsal
Treatment of morton’s neuroma?
wide toe box shoe
CSI
Treatment of complex regional pain syndrome?
Referral to pain management specialist
Sympathetic blockade relieves symptoms
