Foot and Ankle 1 Flashcards
How many tarsal bones are there?
7
What are the 2 tarsals bones in the proximal group?
Talus and Calcaneus
What tarsal bone is in the intermediate group?
Navicular
What tarsal bones are in the distal group?
Cuboid, Lateral Cuneiform, Intermediate Cuneiform and Medial Cuneiform
What are the 4 parts of the metatarsal?
Metatarsal Head, Metatarsal Neck, Metatarsal Shaft, Metatarsal base.
What are the 3 parts of the phalangeal bones?
Distal Phalanges, Intermediate Phalanges, Proximal Phalanges
What is the name of the joint between the distal and intermediate phalanges?
Distal Interphalangeal Joint
What is the name of the joint between the intermediate and proximal phalanges?
Proximal Interphalangeal Joint
Where is the Interphalangeal Joint?
On the first digit, in between distal and proximal phalange
What is the name of the joint between the metatarsals and proximal phalanges?
Metatarsophalangeal Joint
What are the primary ossification centres of the foot and ankle?
Phalanges
Metatarsals
Cuboid
Talus
Calcaneus
What are the secondary ossification centres of the foot and ankle?
Phalanges (epiphyses)
Metatarsals (epiphyses)
Cuneiforms
Cuboid
Navicular
Talus
Calcaneus
What are the 3 regions of the foot?
Hindfoot
Midfoot
Forefoot
What bones are in the Hindfoot?
Talus and Calcaneus
What bones are in the Midfoot?
Navicular, Cuboid and Cuneiforms
What bones are in the forefoot?
Metatarsals and Phalanges
What are the 3 bones of the ankle?
Talus, Tibia and Fibula
What are the ROM for the foot and ankle?
dorsiflexion, plantarflexion, inversion, eversion
What are the routine projections for a foot x-ray?
DP/AP
Medial Oblique
Lateral
What are the routine projections for an ankle x-ray?
AP
Mortise
Lateral
What are the routine projections for Tibia and Fibula X-Ray?
AP
Lateral
What are clinical indications for the foot?
foot trauma
bony tenderness at the base of the 5th metatarsal
bony tenderness at thenavicular bone
inability to weight-bear more than four steps
non-traumatic foot pain
What are clinical indications for the ankle?
ankle trauma
bony tenderness at the posterior edge or the tip of the lateral malleolus
bony tenderness at the posterior edge or the tip medial malleolus
inability to weight bear
non-traumatic ankle pain
What are clinical indications for the tib/fib?
trauma
obvious deformity following major midshaft impaction
suspected foreign body
inability to weight bear
osteomyelitis
What is a DP routine projection X-ray of the foot?
Dorsoplantar - Fromthetoptothebottomofthefoot.
What are the additional x-ray projections of the foot?
Calcaneus ;
Axial
Lateral
What are the additional x-ray projections of the ankle?
AP Stress View
What are the clinical indications for a calcaneus x-ray projection?
fall from a significant height onto feet
axial loading on the talus during deceleration in a motor vehicle accident
inability to weight bear
violent twisting injuries
pathological processes e.g. osteoporosis, tumours or cysts
What are the clinical indications for an AP stress view projection?
Suspicion of syndesmotic injury after trauma
What are the additional x-ray projections of the foot?
Calcaneus;
Axial
Lateral
base of metatarsal joint forms tarsometatarsal joint - all of them together are called what?
Lisfranc joint
What is inversion of the foot?
sole of foot rolling inwards
What is an evulsion fracture?
fragment of bone has come off when a tendon has been ripped
When would the Ottawa ankle rules be applied?
When the patient is over 2 years old, with ankle or midfoot pain / tenderness within the setting of trauma
What are the Ottawa ankle rules for the ankle?
Pain in the malleolar zone AND
Bone tenderness at posterior edge or tip oflateralmalleolus OR
Bone tenderness at posterior edge or tip ofmedialmalleolus OR
Inability to bear weight both immediately after injury ANDin ED.
Why were the Ottawa rules created?
To reduce A&E wait times and not subjecting patients to ionisating radiation and cost
What are the Ottawa ankle rules for the foot?
Pain in the midfoot zone AND
Bone tenderness at base of 5th metatarsal OR
Bone tenderness at navicular OR
Inability to bear weight both immediately after injury AND in ED.
How do you know if the ankle is in mortise view and not AP view?
Mortise view slightly internally rotated 20 degrees meaning fibula is not superimposed.
In an AP view, the fibular is superimposed.
In an axial calcaneus x-ray, why is the tube tilt at 40 degrees cephalad?
To elongate the calcaneus
