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Musculoskeletal > Foot Problems > Flashcards

Foot Problems Flashcards

1
Q

What are some of the general non operative treatment options for foot problems?

A 
Analgesia 
Physiotherapy 
Weight loss 
Shoe wear modification 
Activity modification 
Orthotics
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2
Q

What are some common forefoot problems?

A 
Hallux valgus 
Hallux rigidus
Lesser toe deformities
Morton’s neuroma
Metatarsalgia
Rheumatoid Forefoot
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3
Q

What are the symptoms of hallux valgus?

A

Pressure symtoms from shoe wear
Pain form crossing over of toes
Metatarsalgia

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4
Q

What is the pathogenesis of hallux valgus?

A

Lateral angulation of great toe
Tendons pull realigned to lateral of centre of rotation of toe worsening deformity
Sesamoid bones sublux
As deformity progresses abnormalities of lesser toes occur

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5
Q

How is a diagnosis of hallux valgus made?

A

Clinical examination

Xray

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6
Q

What are the management options for hallux valgus?

A 
Shoe wear modification 
Orthotics 
Activity modification 
Analgesia 
Release lateral soft tissues 
Osteotomy 1st metatarsal +/- proximal phalanx
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7
Q

What is hallux rigidus?

A

Osteoarthritis of 1st MCP

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8
Q

What are the symptoms of hallux rigidus?

A

Pain often at extreme of dorsiflexion

Limitation of range of movement

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9
Q

What are the management options for hallux rigidus?

A 
Activity modification 
Shoe wear with rigid sole 
Analgesia 
Cheilectomy 
Arthrodesis 
Arthroplasty
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10
Q

What is the aetiology of lesser toe deformity?

A 
Imbalance of flexors/extensors
Shoe wear 
Neurological 
Rheumatoid arthritis 
Idiopathic
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11
Q

What are the general symptoms of lesser toe deformities?

A

Pain from dorsum

Pain from plantar side

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12
Q

What are the treatment options for lesser toe deformities?

A 
Activity modification 
Shoe wear (flat shoes with high toe box) 
Orthotic insoles 
Flexor to extensor transfer 
Fusion of interphalangeal joint 
Release metatarsophalangeal joint 
Shortening osteotomy of metatarsal
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13
Q

What is the aetiology of Morton’s neuroma?

A

High healed shoes

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14
Q

What are the symptoms of Morton’s neuroma?

A

Typically affects 3rd flowed by 2nd webspace/toes
Neuralgic burning pain into toes
Intermittent
Altered sensation in webspace

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15
Q

How is a diagnosis of Morton’s neuroma made?

A

USS/MRI

Mulder’s click

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16
Q

What is the management for Morton’s neuroma?

A

Injection for small lesions

Excision of lesion including a action of normal nerve

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17
Q

What is the treatment for rheumatoid forefoot?

A

Shoe/orthotics/activity modification
1st MTPJ arthrodesis
2-5th oe excision arthroplasty

18
Q

What are the symptoms of dorsal foot ganglia?

A

Pain from pressure of shoewear

Pain from underlying problem

19
Q

What is the treatment for dorsal foot ganglia?

A

Aspiration

Excision

20
Q

What are the treatment options for mid foot arthritis?

A

Activity/shoewear/orthotics
Xray guided injections
Fusion operation

21
Q

What are the treatment options for plantar fibromatosis?

A

Avoid pressure
Shoe wear/orthotics
Excision
Radiotherapy

22
Q

What is an insertional tedinopathy?

A

With 2cm of insertion

23
Q

What is a non-insertional/id-substance tendinopathy?

A

2-7cm of insertion

24
Q

What is achilles tendinopathy associated with?

A 
Non-athletic population 
>40 
Obesity 
Steroids 
Diabetes
25
Q

What are the symptoms of an achilles tendinopathy?

A 
Pain during exercise 
Pain following exercise 
Recurrent episodes 
Difficulty fitting shoes 
Rupture
26
Q

How is a diagnosis of an achilles tendinopathy made?

A

Tenderness
Tests for rupture (Simmonds, Matles)
USS
MRI

27
Q

What are the treatment options for achilles tendinopathy?

A 
Activity modification 
Weight loss 
Shoe wear modification 
Physio 
Extra-corporeal shockwave treatment 
Immobilisation 
Gastrocnemius recession
Release and debridement of tendon
28
Q

What is fasciosis?

A

Chronic degenerative change, fibroblast hypertrophy, absence inflammatory cells, disorganised and dysfunctional blood vessels and collagen, asvascularity

29
Q

What is the aetiology of plantar fasciitis?

A

High intensity or rapid increase in training
Running with poorly padded shoes or hard surfaces
Obesity
Occupations involving prolonged standing
Foot/lower limb rotational deformities
Tight gastro-soleus complex

30
Q

What are the symptoms of plantar fasciitis?

A 
Pain first thing in morning
Pain on weight bearing after rest
Post-static dyskinesia
Pain located at origin of plantar fascia
Frequently long lasting – 2 years or more
31
Q

What is the differential diagnosis of plantar fasciitis?

A

Nerve entrapment syndrome
Arthritis
Calcaneal pathology

32
Q

How is the diagnosis of plantar fasciitis made?

A

Mainly clinical

Occasionally x-rays, ultrasound and MRI

33
Q

What are the treatment options for plantar fasciitis?

A 
Rest, change training
Stretching – Achilles +/- direct stretching
Ice
NSAIDs
Orthoses – Heel pads
Physiotherapy
Weight loss
Injections – corticosteroid (good in short term but may make condition worse long term)
Night Splinting
34
Q

What are the symptoms of ankle arthritis?

A

Pain

Stiffness

35
Q

How is a diagnosis of ankle arthritis made?

A

Clinical
Xrays
CT

36
Q

What are the management options for ankle arthritis?

A

Weight loss, activity modification, analgesia, physiotherapy, steroid injections
Arthroscopic anterior debridement
Arthrodesis
Joint replacement

37
Q

What are the management options for tibialis posterior tendon dysfunction?

A

Orthotics
Reconstruction of tendon
Triple fusion

38
Q

What is the treatment for diabetic foot ulcer?

A 
Prevention 
Improve diabetic control 
Smoking 
Vascular supply 
External pressure (splints/shoes/weight bearing) 
Internal pressure (deformity)
Infection 
Nutrition 
Debride ulcers and get deep samples for microbiology 
Correct any deformity to offload area 
Amputation
39
Q

What is the pathophysiology of Charcot’s neuroarthropathy?

A

Lack of proprioception and protective pain sensation

Abnormal autonomic nervous system results in increased vascular supply and bone resorption

40
Q

What are the 3 stages of Charcot’s neuroarthropathy?

A

Fragmentation
Coalescence
Remodelling

41
Q

What are the management options for Charcot’s neuroarthropathy?

A

Prevention
Immobilisation
Correct deformity

Musculoskeletal (27 decks)

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