Foot and ankle Flashcards

1
Q

What is a good view of talar dome?

A

AP view of ankle

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2
Q

Which view is good for mortise joint? What position is the leg in?

A

AP oblique view of ankle
- lower leg is in IR

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3
Q

What is calcaneal inclination? What is normal?

A

line from bottom of calcaneus to bottom of metatarsals
- normal is 20-30 deg

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4
Q

Pes cavus and pes planus angles

A

pes cavus - > 50 deg calcaneal inclination

pes planus - < 20 deg calcaneal inclination

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5
Q

What is tarsal coalition? What view can this be seen in?

A

unions of bones in foot that are not normal
- seen in lateral view of the ankle

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6
Q

Ottawa Ankle and Foot Rules

A

Ankle
- bone tenderness at posterior edge or tip of lateral malleolus OR
- bone tenderness at posterior edge or tip of medial malleolus OR
- inability to bear weight both immediately and in ED for 4 steps

Foot
- bone tenderness at base of 5th metatarsal OR
- bone tenderness at navicular OR
- inability to bear weight both immediately and in ED for 4 steps

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7
Q

1st imaging study for suspected stress (fatigue) including sacrum, excluding vertebrae

A

x-ray

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8
Q

Next imaging study for suspected stress (fatigue) fx, excluding hip and vertebrae, negative radiographs

A
  • repeat x-ray in 10-14 days
  • MRI
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9
Q

What is a fatigue fx?

A

abnormal stress to normal bone

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10
Q

Next imaging study for suspected stress (fatigue) fx, hip (non-lower leg), negative radiographs

A

MRI

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11
Q

Next imaging study for suspected stress (fatigue) fx, excluding vertebrae, negative radiographs, immediate “need-to-know” diagnosis

A

MRI

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12
Q

Follow-up imaging study for return to play eval for confirmed stress (fatigue) fracture, excluding vertebrae

A

MRI

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13
Q

What is an insufficiency fx?

A

normal stress to abnormal bone

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14
Q

Initial imaging for suspected stress (insufficiency) fx of lower extremity, excluding pelvis and hip

A

x-ray lower extremity area of interest

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15
Q

Next imaging study for suspected stress (insufficiency) fx of lower extremity, excluding pelvis and hip, negative radiographs

A
  • MRI
  • x-ray repeat in 10-14 days
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16
Q

Initial imaging of suspected stress (insufficiency) fx, pelvis or hip (non-lower leg)

A

x-ray

17
Q

Next imaging study of suspected stress (insufficiency) fx, pelvis or hip (non-lower leg), negative radiographs

A
  • MRI
  • CT
18
Q

Acute trauma to ankle - initial imaging for adult or child >/= 5 y/o w/ acute trauma to ankle w/ persistent pain for more than 1 week but less than 3 weeks, meet Ottawa Ankle rules (no exclusionary criteria)

A

radiography

19
Q

Acute trauma to ankle - initial imaging for adult or child >/= 5 y/o w/ acute trauma to ankle, negative Ottawa Ankle Rules (no exclusionary criteria present)

A

no imaging recommended

20
Q

Acute trauma to ankle - initial imaging for adult or child >/= 5 y/o w/ acute trauma to ankle, Ottawa Ankle Rules negative, not neurological intact

A

radiography

21
Q

acute trauma to the foot - initial imaging for adult or child >/= 5 y/o w/ acute trauma to foot, negative Ottawa Rules, no suspected abnormalities in regions not evaluated by Ottawa Rules

A

no imaging recommended

22
Q

acute trauma to the foot - initial imaging for adult or child >/= 5 y/o w/ acute trauma to foot, positive Ottawa Rules

A
  • radiography foot
  • radiography foot w/ weightbearing
23
Q

acute trauma to the foot - initial imaging for adult or child >/= 5 y/o w/ acute trauma to foot, negative Ottawa Ankle Rules, suspected pathology to area not addressed by Ottawa Rules (not involving the midfoot; metatarsal-phalangeal joint, metatarsal, toe, tendon, etc)

A
  • radiography foot
  • radiography foot w/ weightbearing
24
Q

chronic ankle pain - initial imaging

A

x-ray ankle

25
Q

chronic ankle pain - next study, chronic ankle pain, ankle radiographs normal, suspected osteochondral lesion

A

MRI

26
Q

What injury is there concern for talar dome osteochondral lesion that is not traumatic?

A

inversion ankle sprain

27
Q

chronic ankle pain - next study, chronic ankle pain, ankle radiographs normal or nonspecific, suspected tendon abnormality

A
  • MRI
  • US
28
Q

chronic ankle pain - next study, chronic ankle pain, ankle radiographs normal, pain of uncertain etiology

A

MRI

29
Q

chronic foot pain - initial imaging, unknown etiology

A

radiography foot

30
Q

chronic foot pain - next imaging study, chronic plantar heel pain, radiographs negative or equivocal, clinical concern includes plantar fasciitis or plantar fascia tear

A
  • US foot
  • MRI foot