Foot/Ankle conditions

Question 1

Plantar fascciitis

Answer 1

ss- Pain on bottom of foot extending from med heal to great toe, first few steps in morn

Px- Windlass test, reproduction of pain w palp of plantar surface, calcaneal squeeze test

POM- conserve, orthotics, short foot exercises

Question 2

Inversion sprain

Answer 2

ss- lat ankle pain, swelling, difficulty weight wearing

px- talar tilt in, ant drawer, Tender over ATFL

POM- conserve

Question 3

Eversion sprain

Answer 3

ss- pain along medial ankle

px- talar tilt ev, external rot, ottawa ankle rules

pom- conserve

Question 4

Ottawa ankle rules

Answer 4

-medial/ lat maleolus (6cm distal)
-inability to weigh bear both immediately and in the ER 4 steps

Question 5

Ottawa foot rules

Answer 5

-bone tenderness at 5th metatarsal
-bone tenderness at nav
-inability to weight bear both immediately and in ER 4 steps

Question 6

High ankle sprai

Answer 6

ss- landing on foot from height, pain in syndesmosis region, swelling/redness, inability to bear weight

px- syndesmosis test +ve, squeeze test on mid calf, Heel thump test

Question 7

achilles tendinopathy

Answer 7

ss- pain along achilles tendon following overuse/trauma, post sharp heel pain, rest relieving

px- pain with active + resisted plantar flex, achilles squeeze test, thompson test

pom- conserve/ pot surg

Question 8

Gastric strain

Answer 8

ss- rapid eccentric load, poping sound, local calf pain

px- antalgica gait away, bruising, tenderness, achilles tendon pain free

POM- conserve

Question 9

anterior shin splints vs medial tibial stress syndrome

Answer 9

Anterior (TA, EHL, EDL)- overuse, heel strike down, down hill running

Medial tibial stress syndrome (TP, FHL, FDL, Soleus)- toe off

Question 10

Shin splints general

Answer 10

s/s-gradual onset of dull achy anterior shin pain after increase/change in physical activity

px- tenderness over posteromedial tibia, Neuro WNL

POM- rest, conserve, training change

Question 11

Compartment syndrome (acute), 6Ps

Answer 11

6 ps- Pain, parenthesis, pulseless paresis, paralysis, pallor

MED EMERG- secondary to single traumatic event (fx etc)

Question 12

Compartment syndrome (chronic)

Answer 12

ss- gradual onset of burning pain in leg and numbness in dorsal of foot, may feel like legs will explode

tx- stop and modify agg factors, surgical after 6 weeks

Question 13

Tibial stress fracture

Answer 13

hx- gradual onset of dull local pain, hx increase in training, increased pain towards end, worse w high impact

px- focal bony tenderness, hop on leg, percussion, tuning fork

pom- xray, stop activity 3-6 w

Question 14

tarsal tunnel syndrome- ss, px, pom

Answer 14

ss- caused by repeated pressure that damages nerve , sharp shooting pain and burning in sole of foot

px- tinnels, sustained pressure over tarsal tunnel

pom- conserve, pot surf

Question 15

Metatarsalgia- ss, px, pom

Answer 15

ss- forforrt pain w increased stress over MT head region, worse w toe off, symptoms of numbness/tingling would indicate mortons neuroma

px- point tenderness over distal end of metatarsal fat pad , ROM not painful

POM- PRICE, metatarsal pad, conserve

Question 16

Mortons neuroma

Answer 16

ss- gradual onset of pain on plantar surface (2-3interspace), like walking on marble, sharp/burn

px- squeeze test, digital nerve stretch (DF foot and extend lat toes)

Question 17

Metatarsalgia stress fx- ss, px, pom

Answer 17

ss- gradual onset of dull diffuse pain, worse w weight bearing

px- antaglic gait, worse w weight bearing, mortons test +ve pain local to shaft

POM- bone scan, MRIbetter, stop high impact activities, slow return to activities

Question 18

Fat pad syndrome- ss, px, pom

Answer 18

ss- occurs when the fat pad at the calcareous atrophies, severe pain w heel strike

px- palpation of the heel will reveal a hard end-feel consistent w bony contract

pom- conserve + orthotics w deep heel cup

Question 19

deep vein thrombosis ss

Answer 19

occurs when a blood clot forms in one of the deep veins in the leg, causing leg pain , swelling (UL), red/discolored, warm sensation, high risk for thrombus

Question 20

what is virchows triad and what is it associated w

Answer 20

venous stasis + impaired venous return + vessel wall injury= hypercouguble state

-deep vein thrombosis

Question 21

deep vein thrombosis px, POM

Answer 21

tender cords nodules in calves (non collapsable veins)
-ul edema
-erythema
-warmth
-purple/blue color
-Neuro WNL

POM- emerg

Question 22

Varicose veins ss, px, pom

Answer 22

ss- asymptomatic

px- should be collapsable, trendelenburg test

POM- duplex doppler US