foot ankle pathology Flashcards
what is mortons neuroma
thickening of the tissue that surrounds the digital nerve that leads from the ball of the foot between the third and fourth toes.
symptoms of mortons neuroma
Tingling, numbness or an unpleasant feeling in the toes.
• Burning pain in the ball of the foot that may radiate into the toes and intensifies with activity.
• The feeling that something is inside the ball of the foot.
• The feeling that a pebble or marble is in the shoe or a sock is bunched up.
what is fibromatosis
fusiform nodular thickenings of the plantar fascia in the mid foot.
presentation of plantar fibromatosis
Patients will usually present with one or more palpable lumps or thickenings in the arch of their foot.
symptoms of plantar fibroomatosis
Not usually painful but may be symptomatic due to physical discomfort.
what is the plantar fascia
tendinous aponeurosis structure
plantar fascia supports
longitudinal archs of the foot
plantar fascia protects
neurovascular structures and tendons from lesions
plantar fascia originates where
posterior to the calcaneus in five bands that separate to involve the digital tendons
plantar fascia insertion
proximal insertion, near the medial tubercle of the calcaneal tuberosity is evaluated
plantar fascia is normal_______ thick
3-4 mm
what is plantar fascitis
painful foot conidtion caused by inflammation of insertion of the plantar fascia on the medial process of calcaneal tuberosity
plantar fascitis symptoms
pain, swelling, warmth of affected are, redness of the adjacent skin
achilles tendon involves
plantar flexion of the ankle
achilles tendon transverse measure and length
maximum of 5-6 mm in transverse dimension (in normal conditions) and 12-15 cm in length
largest and strongest tendon in body
achilles tendon
how does the achilles tendon course
vertically downwards from its gastrocnemius and soleus origin to reach the posterior of the calcaneus, where it inserts
achilles tendon is the only tendon in the ankle to not have
a synovial sheath
achilles tendon has
peritendinous envelope
achilles tendon examined from _______ to _____
examined from its myotendinous junction to the calcanear insertion
should fluid be seen around this tendon in normal condition
no, any fluid is pathological
appearance of partial tendon tear
there is often enlargement of the tendon ( >1 cm) with abnormally hypoechoic or anechoic areas within which correspond to the tear and associated adjacent tendinosis
appearance for full thickness tears
often shows separation of the torn ends with a contour change of the tendon
there is acoustic shadowing at the margins of the tear from sound beam refraction, and adjacent hypoechoic tendinosis
what is tarsal tunnel syndrome
compression, or squeezing, on the posterior tibial nerve that produces symptoms anywhere along the path of the nerve running from the inside of the ankle into the foot.
what is Os trigonum
extra (accessory) bone that sometimes develops behind that ankle bone
Os trigonum connected to the talus by
fibrous band
presence of an os trigonum in one or both feet is
congenital
Os trigonum syndrome caused by
repeated downward pointing of the toes -ballet dancers, soccer players
Os trigonum syndrome refferd to as
“nutcracker injury.”
what is happening in Os trigonum syndrome
os trigonum is crunched between the ankle and heel bones.
os trigonum pulls loose, the tissue connecting it to the talus is stretched or torn - area becomes inflamed
5 risk factors of plantar fascitis
obesity/weight gain large arch tightness of achilles long distnace running shoes with poor arch support
