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MSS Conditions > Foot & Ankle Overuse > Flashcards

Foot & Ankle Overuse Flashcards

1
Q

What is involved in a LE exam?

A
  • Hx w/ mech of injury
  • Observation
  • Palpation
  • ROM
  • Neurovascular
  • Provocative Testing
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2
Q

What does Anterior Talofibular ligament do?

A

Prevents forward displacement (Drawer sign)

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3
Q

What does Posterior Talofibular Ligament do?

A

Prevents backward displacement

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4
Q

What does Calcaneofibular ligament do?

A

Prevents inversion (Talar Tilt)

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5
Q

What are the Classifications of Sprains/Strains?

A
  • Grade I: Gen. intact tensile strength (no gapping), TTP.
  • Grade II: In between, with pain and slight gapping upon stress
  • Grade III: Complete disruption with no tensile strength, sloppy end-feel with gapping/indentation.
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6
Q

Inversion Stress testing classification

A
  • Grade I: No gapping
  • Grade II: Slight gapping
  • Grade III: Major gapping (correlate w/ xray & anterior drawer)
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7
Q

Grade I (1st degree) Lateral ankle sprain

A
  • Ligament integrity
  • Conservative care, wt. bearing w/ brace immediately
  • Minimal swelling
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8
Q

Grade II (2nd degree) Lateral Ankle Sprain

A
  • Partial tearing (slight laxity)
  • “Goose egg” swelling*
  • Lateral stabilizing ankle brace & protected wt bearing
  • Early rehab
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9
Q

Grade III (3rd degree) Lateral Ankle Sprain

A
  • Complete rupture
  • Immediate diffuse swelling, heard “pop” (classic history)*
  • Immobilize 3-4 wks., rehab, and (rarely) surgery
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10
Q

What is the MC type of ankle sprain?

A

Inversion (80%)

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11
Q

What are the Ottawa rules for X-ray?

A
  • Tenderness over inferior or posterior pole of either malleolus
  • Inability to bear weight (4 steps taken independently, even if limping)
  • Tenderness along base of 5th metatarsal or navicular bone
  • Pediatric population <18yo
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12
Q

What is the most critical finding on the Anterior Drawer test?

A

Increased laxity→ Grade III ATF tear

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13
Q

What are the Classifications of overuse

A
  • Grade I: Pain after activity only
  • Grade II: Pain w/ activity, but does not significantly restrict performance
  • Grade III: Pain w/ activity w/ significant performance restriction
  • Grade IV: Pain with activity & rest
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14
Q

What causes Stress fractures?

A

Occur when damage from cyclical loading of a bone overwhelms its physiologic repair capacity

Can lead to gross fx

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15
Q

Who are Stress Fractures common in?

A

Young active adults involved in vigorous (excessive) exercise w/ no single acute event

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16
Q

What are the MC stress fracture sites in runners??

A

Metatarsals (2nd or 3rd) or calcaneus

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17
Q

What are the clinical findings in a stress fracture?

A

Pain at rest accentuated w/ walking, can have swelling & usually point tenderness

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18
Q

What imaging is needed w/ a stress fracture?

A

Xray if suspect (may be neg. initially), bone scan, CT or MRI for definitive diagnosis

19
Q

What is the tx for a stress fracture?

A
  • Rest until healing occurs
  • Resolution of tenderness/ walk w/o pain
  • Signs of healing on Xray
  • Continuous activity can lead to complete fracture
20
Q

What is the tx for Achilles Tendonitis?

A
  • Heel lift (1/4”)
  • Decrease (stop) running/jumping
  • Stretching exercises
  • Arch supports or Custom orthotic if due to hyperpronation
  • NSAIDS/ice
  • No steroid injections!
  • Surgery (excise areas of fibrosis or calcium from tendon, or some bone) seldom needed
21
Q

What is the cause of Peroneal Tendonitis?

A
  • Inflammation from acute trauma
  • Repetitive motion (recurrent rubbing of peroneal tendons on distal end of fibula)
  • Inflammatory arthropathy
22
Q

What are the clinical findings of Peroneal tendonitis?

A
  • Lateral ankle pain
  • Made worse w/ activity
  • Improved w/ rest/NSAIDS
  • Tenderness along peroneal tendons
  • Pain/weakness w/ resisted eversion
23
Q

What is the tx for Peroneal Tendonits?

A
  • RICE
  • NSAIDS
  • Cast for 4-6 weeks if severe
  • Surgery (rare)-inflamed synovium removed
24
Q

Who gets Posterior Tibial Syndrome?

A

Runners w/ hyperpronation

25
Q

What happens as the longitudinal arch flattens?

A

Posterior tibial musculotendinous unit elevates the flattened arch & has ABN stress placed on it

26
Q

Where should you expect a Tibial stress fracture?

A

Middle & distal 1/3 of tibia

27
Q

What imaging is used to dx a Tibial stress fracture?

A

Bone scan, CT, MRI

28
Q

What is the “Classic Hx” of Plantar fasciitis?

A

Severe pain w/ first steps out of bed that gets better as day goes on

29
Q

What causes Plantar faciitis?

A

Result of cumulative impact loading & repetitive microtrauma to plantar fascia, particularly at the insertion into the calcaneus

30
Q

Who is Planatar fasciitis common in?

A
  • Hyperpronators
  • Cavus foot (high arch) often w/ poor shoe support
  • Obese pts
  • Peak in 40-60
  • Runners & military
31
Q

What should Plantar fasciitis be differentiate from?

A

Acute tear→ landing on a bear foot w/ force & feeling a sharp pain

32
Q

What is the Tx of Plantar fasciitis?

A
  • RICE
  • NSAIDS
  • Stretching (rolling pin, frozen can/bottle, night splints, OMT)
  • heel cup
  • PT (iontophoresis)
  • Corticosteroid injections
  • Custom ortho insertions
33
Q

What special test is used for Morton’s neuroma?

A

Squeeze test

Pain b/w metatarsal heads NOT on them

34
Q

What is the tx of a Morton’s neuroma?

A
  • Wider shoe with low heel
  • Soft metatarsal support in shoe proximal to neuroma (spreads MT heads)
  • Corticosteroid injection
35
Q

What is the MC deformity of MTP joint?

A

Bunions (Hallux valgus)

36
Q

Who gets bunions?

A

Women 10x > men d/t tight shoes

37
Q

Where are corns commonly found?

A

5th toe laterally or dorsally

38
Q

What are the tarsal SD?

A

Cuboid – medial plantar edge rotates laterally
Navicular – lateral plantar edge rotates medially

39
Q

What are the OMT techniques for Tarsal SD?

A
  • Crossed thumbs technique
  • HVLA (Hiss whip)
40
Q

What is pathognomonic for a High Ankle sprain?

A

+ Squeeze test & tender to palpation 3 cm proximal to the ankle joint

41
Q

What are the 6 P’s of compartment syndrome?

A
  • Pain
  • Parasthesia
  • Pallor
  • Paralysis
  • Pulselessness
  • Poikilothermia (inability to maintain temp)
42
Q

What is the trauma sign of the anterior compartment?

A

Foot drop

43
Q

What is Hallux rigidis?

A
  • DJD at 1st MTP
  • When flex big toe, doesn’t move hardly at all
44
Q

What is the MC of heal pain in adults?

A

Plantar Fasciitis

MSS Conditions (7 decks)

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