foot and ankle conditions Flashcards
osteoarthritis is most common in
people who have had previous sporting injuries to the ankle
osteoarthritis presentation
reduced movement and pain especially on dorsiflexion
osteoarthritis management
- cheilectomy
- replacement (high failure rate)
- arthrodesis (lower functional outcome, but higher success rate than replacement)
- arthrodesis and replacement
mechanism of ligament strains
inversion injury (going over ankle) which strains lateral collateral ligament
ligament strains presentation
- swelling, stiffness and pain on walking and inversion
- tenderness of lateral collateral ligament, but not lateral malleolus
ligament strains diagnosis
- clinical
- x-ray to rule out fracture if unable to weight bear
ligament strains management
rest, ice, compression and elevation
what is a hallux valgus (bunion)
lateral deviation of the big toe
causes of hallux valgus (bunion)
- age
- obesity
- familial
- wearing heels
- rheumatoid arthritis
hallux valgus (bunion) presentation
- pain and inflammation in big toe
- skin ulceration of big toe
- big toe over-riding second and third toes
hallux valgus (bunion) management
- wearing accommodating shoes
- first web space spacers
- surgery as last resort
what is hallux rigidus
osteoarthritis of first MTP joint
hallux rigidus management
- conservative
- surgical (gold standard is arthrodesis)
pes planus (flat feet) causes
- idiopathic
- neuromuscular conditions (cerebral palsy, spina bifida)
pes planus (flat feet) management
- insoles
- custom footwear
- surgery (last resort)
Achilles tendonitis causes
- repetitive strain
- degeneration
- rheumatoid arthritis
- spondyloarthritides
Achilles tendonitis presentation
- heel pain and swelling that’s worse on activity and relieved by rest
- stiffness and reduced range of movement
Achilles tendonitis diagnosis
ultrasound
Achilles tendonitis management
- rest, ice, compression and elevation
- physiotherapy
- splint
Achilles tendon ruptures are most common in
middle aged and elderly due to degeneration or recent illness
mechanism of Achilles tendon rupture
sudden deceleration with resisted calf muscle contraction (seen in running, jumping or lunges)
Achilles tendon rupture presentation
- severe pain (described like being shot in the back of the leg)
- limping or unable to weight bear
- palpable gap in tendon
- positive Simmonds test (no plantar flexion on squeezing calf)
Achilles tendon rupture management
- 8 weeks of serial casts
- repair and cast
what is plantar fasciitis
inflammation of plantar aponeurosis
plantar fasciitis risk factors
- age
- obesity
- diabetes
- running as hobby
plantar fasciitis presentation
- sharp, stabbing and unilateral heel pain (especially bad when taking first steps of day/after prolonged rest)
- pain may be slightly relieved by mild exercise
- pain worse after being on feet all day
- pain relieved at right
- pain worse when walking on tip toes
plantar fasciitis management
- rest
- physiotherapy
- NSAIDs
- steroid injections
what is morton’s neuroma
neuroma of the inter-digital nerves of plantar surface of foot
morton’s neuroma is most common in
3rd interspace nerve in people who wear high heels
morton’s neuroma presentation
- burning and tingling sensation over metatarsals
- pain radiating down lateral side of 1 toe and medial side of its neighbouring toe
- click and pain on compression of metatarsal heads
morton’s neuroma diagnosis
ultrasound
morton’s neuroma management
- insoles
- steroid injections
- surgical removal of neuroma
