foot differentials Flashcards
ankle fractures MOI?
fall, twist
stress: sudden increase in activity
ankle fractures complaints?
pain- constant/night
instantaneous bruising and swelling in area of injury
ankle fractures differential diagnosis?
sprain
ankle fractures test and measures?
ottawa foot and ankle rules
tuning fork
metatarsal compression/morton’s compression
ankle fracture treatments?
mobilize/ joint mobs
ROM: ABS’s, write your name with your foot
submax isometrics: PF, DF, inv, ev
strengthen once in chronic/after surgery
lateral ankle sprains MOI?
only inversion- CFL
inv and DF- PTFL
inv and PF- ATFL
lateral ankle sprains complaints?
swelling, bruising, swelling within first hour compared to fractures that is immediate.
lateral pain
lateral ankle sprains differential diagnosis?
fracture
lateral ankle sprains tests and measures?
ROM: limited inversion, PF
muscle performance: muscles that do inversion could be impacted/weak
joint play: none
anterior draw test
posterior draw
talar tilt: PF- ATFL, DF- PTFL, neutral- CFL
lateral ankle sprains acute treatment?
open chain
AROM (ABC’s)
submax isometrics (inv, ev)
BAPS board (rock back and forth pain free)
lateral ankle sprains subacute treatment?
closed chain
stabilize into DF
stars (single leg squats)
single leg stand throwing balls or perturbation
bosu ball
lateral ankle sprains chronic treatment?
jumping, running, cutting
functional, sport
medial ankle sprain MOI?
stopping and cutting in sport
football
medial ankle sprains complaint?
medial pain
medial ankle sprains tests and measures?
ROM: eversion and DF most limited
muscle performance: inversion muscles weak/strain
special tests: eversion stress test, kleiger test
medial ankle sprain acute treatment?
open chain
AROM (ABC’s)
submax isometrics (inv/ev)
BAPS board (rock back and forth pain free)
medial ankle sprain subacute treatment?
closed chain
stabilize into DF
stars (single leg squats)
single leg stand throwing balls or perturbation
bosu ball
medial ankle sprains chronic treatment?
jumping, running, cutting
functional, sport
syndesmosis sprain MOI?
tibial torsion on a planted foot
-sports that wear boots
-turf sports with cleats
syndesmosis sprain complaints?
swelling and bruising over malleolus
syndesmosis sprain tests and measures?
ROM: DF most limited
muscle performance: good
special tests: kleiger test and crossed leg test
syndesmosis sprain acute treatment?
open chain
AROM (ABS’s)
submax isometrics (inv/ev)
BAPS board (rock back and forth pain free)
syndesmosis sprain subacute treatment?
closed chain
stabilize into DF
stars (single leg squats)
single leg stand throwing balls or perturbation
bosu ball
syndesmosis sprain chronic treatment?
jumping, running, cutting
functional, sport
plantar fasciitis MOI?
repetitive overuse
pes cavus
pes planus
plantar fasciitis complaints?
pain 1st thing in the morning
pain with palpation over the medial calcaneal tubercle
pain with WBing
pain with overpressure in great toe extension (DF)
plantar fasciitis differential diagnosis?
tarsal tunnel syndrome
calcaneal stress fracture
plantar fasciitis tests and measures?
palpate over calcaneal tubercle
ROM: DF limited, great toe extension
AROM: full and pain free
PROM: pain with overpressure into great toe extension
joint play: DF
too many toes sign
windlass mechanism pain
look at shoes
plantar fasciitis treatment?
orthotics
stretching: windlass mechanism, gastroc stretch, soleus stretch
transverse tissue massage
acute: ROM (ABC’s)
achilles tendonitis MOI?
repetitive overuse
achilles tendonitis complaints?
posterior ankle pain, aggravated by jumping, running
ages 20-40 (weekend warriors)
insertional: bone tendon junction pain
midsubstance: 2-6cm proximal to insertion
achilles tendonitis differential diagnosis?
retrocalcaneal bursitits
calcaneal stress fracture
stress fractures of fibula or tibia
achilles tendonitis test and measures?
AROM: painful and limited DF
manual muscle: pain with PF
palpation: tender over achilles tendon
test: thompson test
achilles tendonitis insertional treatment?
heel raises on flat ground (slowly lower down) single leg
want some pain
stretch gastoc and soleus
achilles tendonitis midsubstance treatment?
heel raises off of a step (slowly lower down) single leg
want some pain
stretch gastoc and soleus
posterior tibialis tendon insufficiency MOI?
overuse with a flat pronated foot
posterior tibialis tendon insufficiency complaints?
pain at medial ankle along the course of the tendon
aggravated by activities involving WB plantar flexion
posterior tibialis tendon insufficiency tests and measures?
AROM: pain with eversion and PF
too many toes sign
talar bulge
posterior tibialis tendon insufficiency acute treatment?
alphabet
submax isometrics
posterior tibialis tendon insufficiency subacute treatment?
toe curls with towel
make arch and lower it
seated heel/toe raises
seated BAPs board
resistance band inv/ev df/pf
posterior tibialis tendon insufficiency chronic treatment?
standing heel raises
standing BAPs board
SLS with perturbations
step ups
hallux limitus MOI?
overuse
hallux limitus complaints?
decreased DF of the first MTP
pain and swelling in the dorsal aspect of the joint
pain with walking, climbing stairs, etc
tenderness over the dorsal and lateral aspects of the joint
hallux limitus differential diagnosis?
gout
hallux abductovalgus
turf toe
hullux limitus tests and measures?
goni: 1st MTP DF
joint play: decreased 1st MTP
hullux limitus treatment?
toe curls
stanfing arch raises
joint mobs-DF
tarsal tunnel syndrome MOI?
overuse
post-traumatic
valgus foot deformity
tarsal tunnel syndrome complaints?
diffuse burning over posterior leg, or plantar surface of foot/toes
night pain
tarsal tunnel syndrome differential diagnosis?
plantar fasciitis
tarsal tunnel syndrome tests and measures?
tinels over tarsal tunnel
SLR- TED
distal: unable to abduct 5th metatarsal
tarsal tunnel syndrome treatment?
windlass mechanism
