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Foot And Ankle Conditions Flashcards

1
Q

what is achilles tendonitis

A

inflammation of the achilles tendon

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1
Q

what does tendonitis predispose to

A

tendon rupture

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2
Q

risk factors for achilles tendonitis

A

overtraining
quinolone antibiotics
RA, gout

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3
Q

give an example of a quinolone antibiotic

A

ciprofloxacin

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4
Q

pathophysiology of achilles tendonitis

A

repetitive microtrauma, failure of collagen repair with loss of fibre alignments/structure

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5
Q

clinical presentation of achilles tendonitis

A
  • Pain of the Achilles tendon or at its insertion in the calcaneus
  • Morning stiffness
  • Pain and stiffness eases with walking
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6
Q

investigation of achilles tendonitis

A

usually a clinical diagnosis

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7
Q

management of achilles tendonitis

A

activity modification, analgesia, NSAIDs
physiotherapy

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8
Q

who usually presents with achilles tendon rupture

A

> 40

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9
Q

risk factors for achilles tendon rupture

A

diabetes
RA
steroid use

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10
Q

symptoms of achilles tendon rupture

A

sudden deceleration with resisted calf muscle contraction
leads to sudden pain and difficulty weight bearing

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11
Q

clinical signs of achilles tendon rupture

A
  • Weakness of plantar flexion and a palpable gap in the tendon are usually apparent
  • Unable to tiptoe stand
  • Positive calf squeeze (Simmonds) test
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12
Q

usual investigation of achiles tendon rupture

A

US

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13
Q

conservative management of achilles tendon rupture

A

series of casts in the equinus position

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14
Q

surgical management of achilles tendon rupture

A

suture repair of the tendon

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15
Q

what usually causes an ankle fracture

A

inversion injury with a rotational force applied to the foot

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16
Q

what can ankle fractures often affect

A

lateral, medial and posterior malleolus

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17
Q

what is used to classify ankle fractures

A

weber classification (A,B,C)

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18
Q

imaging of ankle fracture

A

AP and lateral x-ray

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19
Q

conservative management of ankle fracture

A

cast or moonboot

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20
Q

operative management of ankle fracture

A

ORIF

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21
Q

what does ORIF stand for

A

open reduction internal fixation

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22
Q

what usually causes an ankle sprain

A

twisted ankle

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23
Q

what is the most common type of ankle sprain

A

lateral

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24
what commonly causes a lateral ankle sprain
inversion of the plantar flexed foot
25
how are ankle sprains graded
- Grade 1: microscopic tear (stretch) - Grade 2: partial tear - Grade 3: complete rupture
26
what is a chronic ankle sprain
recurrent sprains or giving way, persisting for more than 6 months
27
clinical presentation of an ankle sprain
tenderness and swelling bruising functional loss mechanical instability
28
investigations done in ankle sprain
x-ray to rule out fracture
29
management of ankle sprain
PRICE physio
30
what does PRICE stand for in injury management
protection rest ice compression elevation
31
what does a calcaneus fracture usually follow
axial compression e.g. falling from height onto the heel
32
management of calcaneus fracture
cast immobilisation with no weight bearing for 6-12 weeks
33
complication of calcaneus fracture
compartment syndrome
34
what is the cause of claw and hammer toes
acquired imbalance between the flexor and extensor tendons
35
pathophysiology of claw toes
hyperextension at the MTPJ with flexion at the PIPJ and DIPJ
36
pathophysiology of hammer toes
PIPJ flexion, DIPJ extension and neutral MTPJ
37
supportive management of claw and hammer toes
toe sleeves and corn plasters
38
surgical solutions of claw and hammer toes
tenotomy, tendon transfer, arthrodesis, toe amputation
39
pathophysiology of hallux valgus
medial deviation of the 1st metatarsal and lateral deviation of the toe itself
40
who is more likely to get hallux valgus
females
41
name some intrinsic risk factors of hallux valgus
ligament laxity, pes planus, RA, cerebral palsy, 2nd toe amputation
42
extrinsic risk factors for hallux valgus
shoes with heels and narrow toe box
43
clinical presentation of hallux valgus
usually bilateral big to turned towards other toes ulceration/loss of balance
44
conservative management of hallux valgus
analgesia, physio, spacers, wear comfy shoes
45
when may you use surgical management of hallux valgus and what does it include
osteotomies when conservative management fails
46
what is hallux rigidus
osteoarthritis of the first MTPJ
47
symptoms of hallux rigidus
- Painful 1st MTP joint - Stiffness - Pain increases with activity/aggravated by shoes
48
clinical signs of hallux rigidus
- Dorsal exostosis (bone spur) - IPJ hyperextension
49
investigation of hallux rigidus
XR
50
gold standard for surgical management of hallux rigidus
arthrodesis
51
what is a lisfranc injury
tarsometatarsal fracture dislocation
52
clinical presentation of a lisfranc injury
severe midfoot pain inability to bear weight
53
investigation of lisfranc injury
XR: AP and oblique views
54
management of lisfranc injuries
ORIF
55
what is a stress fracture
a break in the bone that happens with repeated injury or stress
56
which toes are most at risk of a stress fracture
2nd, followed by 3rd
57
management of metatarsal stress fracture
prolonged rest in a rigid soled boot
58
what is mortons neuroma
benign fibrotic thickening of a plantar digital nerve due to irritation
59
what is the most common nerve involved in mortons neuroma
third interspace nerve
60
risk factors for mortons neuroma
age: 45-50 obesity female
61
clinical presentation of mortons neuroma
burning pain and tingling that radiates to affected toes pain exacerbated by footwear - relieved by removal of shoe
62
clinical test for mortons neuroma
mulders click test
63
what is mulders click test
medio‐lateral compression of the metatarsal heads (exerted by squeezing the forefoot with your hand) may reproduce symptoms or produce a characteristic 'click'
64
what is the diagnostic test for mortons neuroma
US shows swollen nerve
65
usual management of mortons neuroma
conservative: RICE, weight loss, metatarsal pad or offloading insole
66
what is pes cavus
abnormally high arch of the foot
67
what is pes cavus often linked to
cerebral palsy, polio, spina bifida, charcot-marie-tooth
68
what often accompanies pes cavus
claw toes
69
conservative management of pes cavus
accommodative shoe wear, ankle braces, orthotics
70
what is plantar fasciitis
inflammation of the plantar aponeurosis at its origin on the calcaneus
71
name some risk factors for plantar fasciitis
physical overload diabetes age abnormal foot shape walking on hard floors with poor cushioning
72
clinical signs of plantar fasciitis
- Fullness or swelling on plantarmedial aspect of heel - Localised tenderness on palpation of the plantar aspect of heel and/or plantarmedial aspect of heel - Tinel's test positive for Baxter's nerve
73
management of plantar fasciitis
rest, NSAIDs, physio
74
how long can plantar fasciitis symptoms take to resolve
2 years
75
what is the role of the tibialis posterior tendon
supports the medial arch of the foot
76
what is the most common cause of acquired flat foot in adults
tibialis posterior tendon dysfunction
77
name some risk factors for tibialis posterior tendon dysfunction
obesity increasing age hypertension/diabetes steroid injections
78
clinical presentation of tibialis posterior tendon dysfunction
pain or swelling posterior to the medial malleolus change in foot shape diminished walking/balance
79
management of tibialis posterior tendon dysfunction
physiotherapy, good shoes
80
what causes talus fractures
forced dorsiflexion or rapid deceleration
81
name some risks of talus fractures
AVN osteoarthritis
82
what causes a talar dome margin fracture
excessive inversion/eversion
83
what causes a 5th metatarsal fracture
inversion injury
84
clinical presentation of a 5th metatarsal fracture
pain over lateral border of forefoot, especially with weight bearing

musculoskeletal (30 decks)

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