Foot & Ankle Flashcards
What is the purpose of the anterior drawer test & is there good EBP to support it?
purpose - to test for ligamentous laxity of ATL (primarily) and anterior deltoid.
EBP - for acute testing,
What is the purpose of the medial taller tilt test & is there good EBP to support it?
purpose - test for ligamentous laxity of ATFL, CFL, and PTFL
EBP - spec 0.88 (respectable for ruling in)
What is the purpose of the impingement sign test & is there good EBP to support it?
purpose - test for anterior ankle impingement (causing impairment of tissue between talar dome and tip/fib
EBP - sens 0.95 & spec 0.88
What is the purpose of the syndesmosis squeeze test & is there good EBP to support it?
purpose - test for syndesmosis ankle sprains (high sprain) by causing separation of distal tib/fib interosseous membrane.
EBP - spec (good to rule in)
What is the purpose of the external rotation test & is there good EBP to support it?
purpose - test for syndesmsis ankle sprains by causing separation of distal tib/fib interosseous membrane.
EBP - spec 0.85 (good to rule in)
What is the purpose of the thompson test & is there good EBP to support it?
purpose - test for achilles tendon integrity by squeezing calf to shorten calf muscle, does not cause PF
EBP - sens 0.96 & spec 0.93
What is the purpose of the navicular drop test & is there good EBP to support it?
purpose - less than 3mm drop may indicate need for OTC orthotics (measurement change between loaded and unloaded)
EBP - sens 0.47 & spec 0.80
What is the talocrural impingement CPR?
purpose - test for anterior impingement EBP - (+) with 5/6 signs present 1. anterolateral ankle jt tenderness 2. anterolateral ankle jt swelling 3. pain with forced DF & eversion 4. pain with single leg squat 5. ankle instability
What is the Ottawa ankle rules CPR?
purpose - screens for need of radiograph with ankle or foot injuries.
refer for radio graphs if pain in the malleolar or mid foot area & anyone of the following.
- inability to bear weight both immediately after injury & in the emergency department for 4 steps.
- bone tenderness along any of following areas: distal 6cm posterior edge of tibia or tip of medial malleolus, distal 6cm of posterior edge of fibula or tip of lateral malleolus, base of 5th metatarsal or navicular bone
EBP - sens 0.98 (foot to rule out)
What manual therapy techniques can be used to improve your patients limited DF?
- talocrural AP mobilization
- distal tib-fib AP mobilization
- ankel DF mobilization with movement (improve tibial glide component)
- rear foot distraction manipulation
What manual therapy techniques can be used to improve your patients limited PF?
- talocrural PA mobilization
- distal tib-fib PA mobilization
- rear foot distraction manipulation
What manual therapy techniques can be used to improve your patients limited inversion and/or eversion?
- subtalar lateral glides
- subtalar medial glides
- rear foot distraction manipulation
What manual therapy techniques can be used to improve your patients general mid-foot mobility?
- cuboid manipulation
- metatarsal AP/PA mobilization
- rear foot distraction manipulation
What manual therapy techniques can be used to improve your patients general forefoot mobility?
- metatarsal AP/PA mobilization
What manual therapy techniques can be used to improve your patients 1st MTP mobility?
- 1st MTP mobilization (specific to 1st MTP)
- 1st MTP manipulation (is just general not specific)
This injury usually involves PF and inversion at time of injury?
inversion sprain
This injury is overuse/or incomplete healing and commonly patients complain of pain with stretching and/or push off during gait?
achilles tendonopathy
This injury is has patients reporting pain during the first few steps after non-weight bearing rest (out of bed) or after prolonged walking?
planar fasciitis
This injury can be caused by over/excessive pronation, overuse problems resulting in tendonitis of long flexor and posterior tibias tendon, and/or trauma that may compromise the tarsal tunnel?
tarsal tunnel syndrome
This injury is commonly found with a positive tine’s sign and/or triple compression stress test?
tarsal tunnel syndrome
This injury is commonly reported by patients who have pain during gait and pain with eversion stretch?
- tibialis posterior tendonopathy if chronic
- tendonitis in acute stage
This injury is commonly reported by patients as having pain at toe off during gain and pain with 1st MTP extension stretch. It is commonly seen in ballet performers?
- flexor hallucis tendonopathy
- tendonitis in acute stage
This foot condition has a variety of etiologies including malalignment, ligament laxity, brevity, weak muscle, or tight footwear. The deformity includes medial deviation of the head of 1st metatarsal and base of proximal 1st phalanx and distal phalanx moves laterally.
hallux valgus
This foot condition common findings are pain between 1st and 2nd metatarsal heads after prolonged weight bearing. Can have vascular or neural component that does not change with proper foot wear.
metatarsalgia/morton’s neuroma
This foot condition can occur during childhood or adulthood caused by atrophy of fibular muscles and both motor and sensory nerves. Can progress from lower leg to forearm and hands.
charcot-marie-tooth disease
This foot condition may be diagnosed by observing increased height of longitudinal arches, dropping of anterior arches, metatarsal head lower than hind foot, PF, splaying of forefoot, and claw toes.
pes cavus (high arch)
This foot condition may be diagnosed by observing a reduction in height of medial arch, trauma, excessive pronation, ligament laxity, and/or muscle weakness.
pes planus
This foot condition involves abnormal development of head and neck of talus due to heredity or neuromuscular disorders.
talipes equinovarus
This foot condition results from intrauterine malposition.
talipes equinovarus - postural type
This foot condition includes a permanent PF foot caused by congenital bone deformity, neurological disorders, contracture of gastrocnemius and/or soles, trauma, or inflammatory disease.
equinus
This foot condition has two types caused by congenital, muscle imbalance, or neuromuscular disease such as polio. One type involves medial subluxation of the tarsometatarsal joints and the second form all five metatarsals are adducted.
Metatarsus Adductus
- ridged
- flexed
