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MSK - ABDN > Foot problems > Flashcards

Foot problems Flashcards

1
Q

name some forefoot problems

A
  • hallux valgus
  • hallux rigid
  • morton’s neuroma
  • metatarsalgia
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2
Q

what is hallux valgus

A

bunions

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3
Q

what are the risk factors of hallux valgus

A
  • genetics
  • footwear
  • gender (female)
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4
Q

what are the symptoms of hallux valgus

A
  • pain from footwear
  • pain from toes crossing over
  • metatarsalgia
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5
Q

why would you x-ray someone with hallux valgus

A
  • to show the severity of the deformity

- to rule out degenerative changes

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6
Q

how I hallux valgus managed

A 
operative = release of the lateral soft tissues, osteotomy of the 1st metatarsal
non-operative = analgesia, activity modification, shoe wear modification, orthotics
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7
Q

what is meant by hallux rigidus

A

a stiff big toe

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8
Q

how is hallux rigidus managed

A

operative:

  • cheilectomy (removal of some bone at the head of the 1st metatarsal bone)
  • arthrodesis (immobilising the joint via the fusion of the bones)
  • arthroplasty (surgical reconstruction of a joint)

non-operative:

  • activity modification
  • analgesia
  • modified footwear
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9
Q

what is the gold standard treatment for hallux rigidus

A

arthrodesis

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10
Q

name some lesser toe deformities

A
  • claw toes
  • hammer toes
  • mallet toes
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11
Q

what joint is affected in claw toes

A

both the proximal and the distal interphalangeal joints of the foot

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12
Q

what joint is affected in hammer toes

A

the proximal interphalangeal joints

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13
Q

what joint is affected in mallet toes

A

the distal interphalangeal joitns

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14
Q

what are the causes of lesser toe deformities

A

shoe wear, neurological problems, rheumatoid arthritis, imbalance between the flexors and the extensors

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15
Q

what are the treatment options for lesser toe deformities

A

non-operative = activity modification, shoe wear modification (flat shoes with high toe box) and orthotic insoles

operative = flexor to extensor transfer, fusion of the interphalangeal joints, shortening of the metatarsal bone

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16
Q

what is Morton’s neuroma

A

compression of the plantar digital nerve in the foot (usually between the 3rd and 4th toe) - due to the thickening of the transverse inter metatarsal ligament

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17
Q

who is most affected by Morton’s neuroma

A

women between 40-60 and more in those who wear high heeled shoes

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18
Q

what are the symptoms of Morton’s neuroma

A

burning and altered sensation in the affected webspace - the symptoms are intermittent

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19
Q

what is the best tool for the diagnosis of Morton’s neuroma

A

USS

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20
Q

what is meant by Mulder’s click

A

this is a clinical test that can be used to help the diagnosis of Morton’s neuroma - this is when pain is provoked by squeezing the metatarsal bones together

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21
Q

what is the management of Morton’s neuroma

A
  • injections for small lesions or excision of the lesion
22
Q

what is meant by metatarslgia

A

this is a symptom associated with pain and inflammation in the ball of the foot

23
Q

what is rheumatoid forefoot

A

this is an autoimmune (type 3 hypersensitivity) disease of the foot - there may be signs of hallux values, metatarsalgia and toe deformities

24
Q

what is the treatment of rheumatoid forefoot

A
  • activity modification
  • shoe wear modification
  • orthotics
  • 1st metatarsalphalangeal arthrodesis
  • arthroplasty
25
Q

name some mid foot problems

A

ganglia, osteoarthritis, plantar fibromatosis

26
Q

where do dorsal foot ganglia arise from

A

from joints or tendon sheaths - usually from underlying pathology

27
Q

what is the treatment of dorsal foot ganglia

A

aspiration or excision

28
Q

what is plantar fibromatosis

A

this is known as dupuytrens of the foot - there is thickening of the fascia of the foot and nodular development

29
Q

what is the treatment of plantar fibromatosis

A

radiotherapy, excision, shoe wear modification and orthotics

30
Q

name some hind foot problems

A
  • achilles tendonitis
  • plantar fasciitis
  • ankle osteoarthritis
  • cavernous foot
  • posterior tibilais tendon dysfunction
31
Q

in which people is achilles tendonopathy most common

A

non-athletic, obese people, those with diabetes, those on steroids and generally >40 years old

32
Q

in which people is para-tendonopaty most common

A

athletic populations

33
Q

what is achilles tendonitis not the correct name

A

there is very little inflammation

34
Q

what are the symptoms of achilles tendonopathy

A

pain during and following exercise, difficulty putting on shoes

35
Q

what are the risk factors for achilles tendonopathy

A

obesity, diabetes, steroid use, age (>40)

36
Q

what clinical test is used to assess achilles tendon rupture

A

Simmond’s test

37
Q

what is the treatment of achilles tendonopathy

A

non-operative = weight loss, activity modification, shoe wear modification, physiotherapy, shock wave treatment, immobilisation

operative = gastrocnemius resection, release of the tendon

38
Q

what is plantar fasciitis and what are the symptoms

A

chronic degenerative changes of the plantar fascia in the foot - proliferation of fibroblasts

Symptoms = pain on weight bearing, pain first thing in the morning, pain located at the origin of the plantar fascia

39
Q

what are the causes of plantar fasciitis

A
  • prolonged standing
  • running I poorly padded shoes
  • obesity
40
Q

what is the differential diagnosis of plantar fasciitis

A

nerve entrapment or arthritis

41
Q

what is the treatment of plantar fasciitis

A

rest, ice, NSAIDs, physiotherapy, weight loss, heel pads, corticosteoid injections, platelet rich plasma, nitric oxide, shockwave therapy

42
Q

what are the symptoms of ankle arthritis

A

pain and stiffness of the ankle

43
Q

what are the management options of ankle arthritis

A
  • activity modification
  • weight loss
  • anlagesia
  • physiotherapy
  • joint replacement surgery
  • steroid injections
  • arthrodesis
44
Q

what is the result of dysfunction of the posterior tibial tendon

A

flattening of the arch of the foot

45
Q

what are the most common symptoms of posterior tibial tendon dysfunction

A
  • flattening of the foot (progressive)
  • inward rolling of the foot
  • pain and swelling of the foot
46
Q

what is the treatment of posterior tibial tendon dysfunction

A

orthotics or surgery

47
Q

in which direction should the heels swing as they rise

A

from valgus to varus

48
Q

what are the management options of diabetic foot ulcers

A
  • stop smoking
  • external pressure
  • surgery to correct deformity and to debris the ulcer
  • surgery to improve vascular supply
  • amputation
  • nutrition referral
49
Q

what is Charcots neuropathy

A

this is rapid bone deconstruction of the foot causing inflammation and swelling

50
Q

how is Charcots neuropathy diagnosed

A

radiographs, MRI and clinically

51
Q

what are the treatment options of Charcots neuropathy

A

surgery to correct the deformity and immobilisation

MSK - ABDN (33 decks)

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