Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MSK > Foot Problems > Flashcards

Foot Problems Flashcards

1
Q

What is the common word for hallux valgus?

A

Bunions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the aetiology of hallux valgus?

A

Genetic (foot shape runs in families)
Footwear (high heels push the forefoot into wedge)
Most common in females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What symptoms are caused by hallux valgus?

A

Pressure symptoms from shoe wear
Painful lump
Pain from toes crossing over
Metatarsalgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the pathogenesis of hallux valgus?

A

Lump is from swollen bursa and osseous anomaly on MT head
Lateral angulation of big toe
Tendon pull reaiigned to lateral of central rotation of toe worsening deformity
Viscous cycle –> inc. pull –> inc. deformity
Sesmoid bones sublux
As deformity progresses –> abnormalities of lesser toes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is used to diagnose hallux valgus?

A

Clinical diagnosis and Xray used (look for appropriate signs, e.g. inc. MT angle, sublux sesmoids etc.)
Exclude assoc. Degen. change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do you treat hallux valgus non-operatively?

A

Orthotics, shoe wear, activity modification, analgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do you treat hallux valgus operatively?

A

Release lateral soft tissue

Osteotomy 1st MT +/- proximal phalanx (recurrence inevitable)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is hallux rigidus?

A

Stiff big toe

OA of 1st toe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In which groups of people does it occur?

A

Peak in young people and 70-80s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the aetiology of hallux ridigus?

A

?multiple episodes of microtrauma –> OA

?Genetic (typical shape of metatarsal head slightly pointed rather than rounded)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the symptoms of hallux rigidus?

A

May be asymptomatic
Pain (esp. on extreme dorsiflexion as this is when osteophytes rub against each other)
Restricted RoM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is hallux rigidus diagnosed?

A

Clinical

Xray - look for features of OA (subchondral cysts, loss of joint space etc.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do you manage hallux rigidus non-operatively?

A

Orthotics, shoe wear, analgesia, activity modification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do you manage hallux rigidus operatively?

A

Gold standard is arthrodesis

May also do arthroplasty or cheilectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is cheilectomy?

A

Removal of osteophytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the appearance of claw toes?

A

Hyperextended MTPJ, flexed DIP and PIP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the appearance of hammer toes?

A

Flexed PIP, straight/hyperextended PIP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the appearance of mallet toe?

A

Flexed DIP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What symptoms can occur from lesser toe deformities?

A

Pain (metatarsalgia) on plantar side

Deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How can you manage lesser toe deformities non-operatively?

A

Orthotics, activity modification, shoe wear, analgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How can you manage lesser toe deformities operatively?

A

Flexor –> extensor transfer
Fusion of IP joint
Release of MTP joint
Shortening osteotomy of metatarsal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Morton Neuroma?

A

Mechanically induced degenerative neuropathy (e.g. freq. wearing of heels) leading to common digital nerve becoming relatively tethered to one metatarsal and movement of the adjacent metatarsal causes mechanical shearing

IT IS A THICKENING OF THE NERVE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Where does the common plantar digital nerve run and what is its function?

A

Runs between MTs and supplies sensation to the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where does Morton neuroma most commonly occur?

A

2nd and 3rd webspace (as these are the smallest gaps)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What symptoms are caused by Morton neuroma?
Intermittent burning sensation in interdigital space (that spreads into the toes) Altered sensation in webspace
26
How do you diagnose Morton neuroma?
Clinical - can use Mulder's click | USS
27
What is Mulder's click?
Pressing the two MT heads together and putting pressure on webspace should lead to clicking noise and ilict pain/paraesthesia radiating tot eh affected toes
28
How do you treat Morton neuroma?
If small - injection (blind or with USS guidance) | If bigger - excision of neuroma and section of healthy tissue (SE: numbness and recurrence is 30%)
29
What is metatarsalgia?
A group of symptoms including burning/aching pain on the balls of the feet spreading to the toes
30
What can cause metatarsalgia?
Arthritis, bursitis, neuralgia, Freiberg disease, neuromata, synovitis, tight gastrocn
31
How can you non-operatively manage rheumatoid forefoot?
Footwear, orthotics, analgesia, activity modification
32
How can you operatively manage rheumatoid forefoot?
Gold standard - 1t MTPJ arthrodesis and 2-5th toe excision arthroplasty (joint surface and bones removed, surfaces remodelled and left to scar together)
33
What are dorsal foot ganglia?
Benign transilluminating liquid filled nodules that arise from the joint/tendon sheath
34
What are the aetiology of dorsal foot ganglia?
Idiopathic | Underlying arthritis/other tendon pathology
35
What symptoms can be experienced in dorsal foot ganglia?
Pain from pressure (shoewear)
36
How can you manage dorsal foot ganglia?
Non-op: aspiration/hit with the bible (hit it hard enough that it pops) Op - excision (recurrence 50% (not worth it))
37
What are the types of midfoot arthritis?
Post-traumatic OA, RA, OA
38
How do you manage midfoot arthritis?
Non-op: activity modifications, shoewear, orthotics etc. Injections (XRay guided) Fusion
39
What is plantar fibromatosis otherwise known as?
Duputyrens of the foot
40
What is plantar fibromatosis?
Thickening of the plantar fascia (initial stages involve development of nodules in the plantar fascia)
41
What symptoms are associated with plantar fibromatosis?
Rubbing of nodules causes pain Contracture of toes in later stages (usually nearest the highest part of the arch of the foot) Usually asymptomatic unless v. large or on weight bearing area
42
What is the prognosis of plantar fibromatosis?
It is progressive
43
How do you manage plantar fibromatosis?
Avoid pressure, orthotics Excision RT Combination RT and excision (higher complications vs lower recurrence rate)
44
Define tendonitis
Inflammation of the tendon
45
Define tendinosis
Non-inflammatory degeneration of the tendon (usually from repetitive microtrauma)
46
Define paratenonitis
Inflammation of the surrounding tendon sheath (the paratenon)
47
Define insertional tendinopathy
Tendinopathy within 2cm of the insertion of the tendon
48
Define non-insertional tendinopathy
Tendinopathy 2cm-7cm away from the insertion of the tendon
49
What kind of bursitis may cause posterior ankle pain?
Retrocalcaneal or superficial calcaneal
50
How do you diagnose paratenopathy?
Requires a biopsy for diagnosis
51
Who is achilles paratenonitis more common in?
Younger, athletic populations (30s-40s)
52
Who is achilles tendonosis more common in?
Non-athletic populations, >40yo | RF include DM, obesity and steroid use
53
What symptoms are associated with achilles tendinopathy?
During on posterior aspect of ankle following exercise/during exercise Difficulty with plantarflexion Difficulty fitting shoes Tenderness over tendon
54
What must you always check for in achilles tendinopathy?
For rupture - using Matle's/angle of the dangle or Simmonds test
55
What is a positive Matle's test?
Dorsiflexion of affected foot
56
What is a positive Simmonds test?
Failed plantarflexion of foot on squeezing the calf (this can be very sore!!)
57
What imaging can you use for suspected achilles tendinopathy?
USS/MRI
58
What is management for achilles tendinopathy?
Non-op: activity modification, wt loss, shoe wear modification, orthotics, physioterhapy (eccentric stretching), ECSW treatment, immobilisation (in knee cast) Op: gastrocn. recession, release and debridement of tendon
59
What is plantar fasciitis?
Disorder of the connective tissue supporting the arch of the foot (chronic degenerative change with fibroblast hypertrophy - not inflammatory!)
60
What is the aetiology of plantar fasciitis?
``` Unable to make ECM Microtears Athletes: increase in training/running on hard ground/improper footwear Obesity Occupations with prolonged standing Lower limb/foot rotational deformities Tight gastro-soleus complex ```
61
What symptoms are associated with plantar fasciits?
Pain at origin of plantar fascia first thing in the morning/after rest Pain long lasting (>2y+)
62
What are differential diagnoses for plantar fasciits?
Nerve entrapment, arthritis, calcaneal pathology
63
How do you diagnose plantar fasciitis?
Mainly clinical | Occassionally use XRay, MRI or USS
64
What is first line treatment for plantar fasciitis?
Rest, changing training, ice, NSAIDs, orthoses, physio, wt loss, night splinting
65
What is 2nd line treatment for plantar fasciitis?
Corticosteroid injections (only for short term, may make worse long term?)
66
What is 3rd line treatment for plantar fasciitis?
ECSW therapy, topaz plasma coblation, nitric oxide, platelet rich plasma, endoscopic/open surgery
67
What is the mean age of presentation of ankle arthritis?
46yo
68
How common is ankle arthritis?
Relatively uncommon (esp compared to knee and hip)
69
What symptoms are associated with ankle arthritis?
Pain and stiffness
70
How do you diagnose ankle arthritis?
Clinical Xray CTS - to exclude adjacent joint arthiritis
71
How do you treat ankle arthritis?
Non-op: wt loss, activity modification, analgesia, physiotherapy, steroid injections Op: gold standard is arthrodesis, if symptoms purely ant. can do arthroscopic ant. debridement Arthroplasty
72
What results from posterior tibial tendon dysfunction?
Lowering of the longitudinal arch of the foot (i.e. planovalgus or acquired adult flatfoot)
73
How many clinical stages are there of planovalgus?
4
74
How do you diagnose posterior tibial tendon dysfunction?
Mostly clinical - single and double heel raise | MRI to assess tendon
75
What is involved in a single and double heel raise?
Heels should swing from valgus to varus as heel raises
76
What are signs and symptoms of posterior tibial tendon dysfunction?
Asymptomatic or medial/lateral pain | Heel is valgus - can impinge on medial malleolus --> pain
77
How do you treat posterior tibial tendon dysfunction?
``` Orthotics - medical arch support Reconstruction of the tendon (tendon transfer) Triple fusion (subtalar, talonavicular, calcaneocuboid) ```
78
What is the aetiology of diabetic food ulceration?
Diabetic neuropathy - patient is unaware of the trauma Diabetic autonomic neuropathy - lack of sweating/normal sebum production (--> dry, cracked skin that is more sensitive to minor trauma) Poor vascular supply Lack of patient education
79
How do you manage diabetic foot ulcerations?
Prevention is key Modify main determinants to healing: diabetic control, smoking, vascular supply, external factors (e.g. splints, shoes, wt bearing), internal pressure (deformity), infection and nutrition Op: improve vascular supply, debride ulcers, get deep samples for microbiology, correct deformity to offload area, amputation
80
What is charcot neuropathy?
Deformation of joints and bones of foot, typically PAINLESS
81
What is the cause of charcot neuropathy?
Any cause of neuropathy (DM most common) | Historically most common with syphilis
82
What is the pathophysiology of charcot neuropathy?
Neurotraumatic - loss of proprioception and protective pain sensation Neurovascular - abnormal autonomic nervous system results in increased vascular supply and bone resorption
83
What is charcot neuropathy characterised by?
Rapid bone destruction occurring in 3 stages: Fragmentation Coalscence Remodelling
84
What complications can arise from charcot neuropathy?
Prominent areas --> high risk of ulceration | Deformity --> ulceration --> infection --> amputation
85
How do you diagnose charcot neuropathy?
High index suspicion Consider in any diabetic with acutely swollen, erythematous foot, esp. w. neuropathy Greater than 3 degree difference between limbs Radiographs and MRI
86
How do you manage charcot neuropathy?
Prevention!! Immobilisation/non-wt bearing until acute fragmentation resolved Correct deformity

MSK (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions