Foot & Ankle Flashcards
Palp lateral foot & ankle
Distal fibula
* Lateral malleolus
* Peroneal tubercle (splits fib longus
and brevis) – on calcaneus
* Calcaneus
* Sinus tarsi (tunnel b/w calc + talus)
* Cuboid
* Styloid process of 5th met
* 5th metatarsal
* 5th toe
Palp medial foot & ankle
Distal tibia
* Medial malleolus
* Sustentaculum tali (anteromedial calc
– attachment point, deltoid and spring
lig.)
* Medial calcaneus
* Head of talus (articulates with
navicular)
* Navicular (and navicular tubercle)
* Medial cuneiform
* First metatarsal
* Great toe
dorsal palp foot & ankle
Phalanges (distal, middle, proximal)
* Metatarsals
* Cuboid
* Cuneiforms: medial, intermediate,
lateral
* Navicular
* Talar head (articulates with navicular)
palp Plantar foot & ankle
Calcaneus
* Medial tubercule of calcaneus
(plantar fascia attachment –
clinically relevant)
* Sesamoid bones (under 1 st MTP)
* Metatarsals 4-2 & heads of
metatarsals
* Phalanges
Lateral ankle ligaments - palp
Anterior talofibular
* Lat mal – talar body (runs anteromedially)
Calcaneofibular
* Lat mal – Lat calc (runs inferoposterior)
Posterior talofibular
* Lat mal - post talus (runs horzontially)
Posterior inferior tibiofibular
* Post lat mal – post distal tib (runs slightly oblique
Anterior inferior tibiofibular
* Ditstal ant. Tib. – ant. Lat. mal (runs horizontal)
Medial ankle soft tissue palp
1st metatarsal bursa
spring ligament
deltoid ligament
+ deep posterior muscle compartment
Posterior & plantar soft tissue palp
achilles tendon
calcaneal bursa
plantar fascia
AROM - foot & ankle
weight bearing:
dorsiflexion/plantarflexion at talocrural joint
inversion/eversion at subtalar joint
Toe/MTP flexion/extension
non-weight bearing:
dorsiflexion/plantarflexion at talocrural joint
inversion/eversion at subtalar joint
abduction/adduction at subtalar joint
Joint play - Foot & ankle
Talocrural - Traction, PA/AP glide
Subtalar - Spring
Mid Tarsal - AP glide/spring/shear
Metatarsals - Shear
MTP/IP - Traction, Medial-lateral gapping
Collateral ligament integrity tests - foot & ankle
Anterior draw test
- tests anterior talo-fibular ligament
- +ive pain and/or excessive laxity
- SN = 58%, moderate
- SP = 100%, high
Ankle Syndesmosis Injury
Squeeze test
- tests inferior tibiofibular joint
- +ive pain on squeezing
- SN = 30%, low
- SP = 93%, high
Tendon Pathology tests - Ankle & foot
Thompson test
- tests for achilles rupture
- +ive lack of ankle plantar flexion
- SN = 96%, high
- SP = 93%, high
Ottawa Ankle & foot rules diagnostic palpation
Deliberately palpate the soft tissue and bony structures for
- reproduction of pain in key areas (see below)
- areas of swelling +/- warmth (tissue texture change associated with acute injury & inflammation)
Articulation Talocrural & subtalar joints
Dorsiflexion/Plantarflexion
Inversion/Eversion
Traction
Subtalar joint springing
AP glide/shear of talus
Articulation Midfoot & Forefoot
Talonavicular joint shear (rotation)
Cuboid/5th metatarsal shear
Cuneiforms spring
Shear of metatarsals
Toes - flexion, Extension, Traction, Gapping
