foot problems

Question 1

non-op treatment options for foot + ankle conditions

Answer 1

analgesia 
shoe-wear modification
activity modification 
weight loss
physiotherapy 
orthotics

Question 2

forefoot problems

Answer 2

hallux valgus
hallux rigidus 
lesser toe deformities
morton's neuroma
metatarsalgia 
rheumatoid forefoot

Question 3

hallux valgus

Answer 3

bunions

Question 4

hallux valgus aetiology

Answer 4

genetic

foot wear

Question 5

symptoms hallux valgus

Answer 5

pressure symptoms from shoe wear - bursitis over MTP joint

pain from crossing over of toes - can become ulcerated

metatarsalgia - weight distribution to lesser metatarsal heads

Question 6

pathogenesis hallux valgus

Answer 6

lateral angulation of great toe

tendons pull realigned to lateral of centre rotation of two worsening deformity

Question 7

diagnosis hallux valgus

Answer 7

clinical

x-ray

Question 8

management hallux valgus - non-op

Answer 8

shoe wear modificatino
orthotics
activity modification
analgesia

Question 9

management hallux valgus - op

Answer 9

release lateral soft tissues

osteotomy 1st metatarsal

Question 10

hallux rigidus

Answer 10

OA of 1st MTP joint

Question 11

claw toes

Answer 11

flexion at proximal and distal interphalangeal joint

Question 12

hammer toras

Answer 12

flexion of proximal interphalangeal joint and dorsiflexion MTP joint

Question 13

mallet toes

Answer 13

flexion at distal interphalangeal joint

Question 14

aetiology of lesser toe deformities

Answer 14

imbalance between flexors/extensors
shoe-wear
neurological 
RA
idiopathic

Question 15

symptoms lesser toe deformities

Answer 15

deformity
pain from dorsum
pain from planter side (metatarsalgia)

Question 16

non-op Rx lesser toe deformities

Answer 16

activity modification
shoe wear
orthotic insoles

Question 17

morton’s neuroma

Answer 17

interdigital neuralgia

mechanically induced degenerative neuropathy

Question 18

symptoms morton’s neuroma

Answer 18

typically 3rd followed by 2nd webspaces/toes

neuralgic burning into toes

Question 19

diagnosis morton’s neuroma

Answer 19

clinical
Mulder’s click
USS
MRI

Question 20

management morton’s neuroma

Answer 20

injection steroid for small lesions

surgery: excision of lesion incl section normal nerve

Question 21

metatarsalgia

Answer 21

symptoms

any pain coming from forefoot

Question 22

rheumatoid forefoot

Answer 22

pain 
hallux vargus
hammering of toes
rubbing + crossing over of toes
pressure areas w obvious bursitis

Question 23

management rhumatoid forefoot

Answer 23

shoe wear
orthotics
activity

1st MTPJ arthrodesis
2-5th toe excision arthroplasty

Question 24

midfoot problems

Answer 24

ganglia
OA
plantar fibromastosis

Question 25

aetiology dorsal foot ganglia

Answer 25

idiopathic
underlying arthritis
underlying tendon pathology

Question 26

where do dorsal foot ganglia arise from

Answer 26

joint or tendon sheath

Question 27

symptoms dorsal goot ganglia

Answer 27

pain pressure of footwear

pain underlying problem

Question 28

treatment dorsal root galnglia

Answer 28

aspiration

excision

Question 29

treatment midfoot arthrtitis

Answer 29

activity
footwear
orthotics
injections

fusoin

Question 30

plantar fibromatosis

Answer 30

‘dupuytren’s of foot’

usually asymptomatic unless very large or on weight bearing area

Question 31

planter fibromatosis Rx

Answer 31

avoid pressure
footwear modif

operative excision
radiotherapy
combo surg + radio

Question 32

hindfoot problems

Answer 32

achilles tendonitis/tendinosis
plantar fasciitit
tibialis posterior dysfunction
cavovarus foot

Question 33

achilles tendonitis/teninosis

Answer 33

degenerative/overuse with little inflammation

tendinopathy to describe symptoms

Question 34

symptoms achilles tendinopathy

Answer 34

pain during + following exercise
recurrent episodes
hard put shoes on

Question 35

diagnosis achiles tendinopathy

Answer 35

tenderness
test for rupture

USS
mRI

Question 36

non op Rx achiles tendinopathy

Answer 36

activity mod 
weight loss
footwear mod
physio 
immobilisation - below knee case

Question 37

op Rx achilles tendinopathy

Answer 37

gastrocnemius recession

release and debridement tendon

Question 38

fasciosis

Answer 38

chronic degenerative change, fibroblast hypertrophy, absence inflammatory cells
disorganised, dynfunctional blood vessels and collagen
avascularity

Question 39

plantar fasciitis aetiology

Answer 39

not known
obesity
occupation w prolonged standing

Question 40

plantar fasciitis symptoms

Answer 40

pain morning
pain weight bearing after rest
pain origin planter fascia

Question 41

diagnosis plantar fasciitis

Answer 41

clinical

occasional x-ray, USS, mri

Question 42

Rx plantar fasciitis

Answer 42

rest
stretching 
ice
NSAIDs
orthotics
physio 
weight loss
corticosteroid injectoin 
nigh splinting

Question 43

posterior tibial ligament dysfunctoin

Answer 43

acquired adult flat foot planovalgus foot

Question 44

diagnosis posterior tibial ligament dysfunction

Answer 44

largely clinical

MRI

Question 45

management posterior tibial ligament dysfunctoin

Answer 45

orthotics - medial arch support
reconstruction tendon
triple fusion

Question 46

charcots neuropathy 2 therories

Answer 46

neurotraumatic: loss proproiception and protective pain sensation
neurovascualar: abnormal autonomic NS leads to inc vascular supply bone and increased bone reabsoprtio n

Question 47

charcot’s neuropathy

Answer 47

rapid bone reabsorption

1. fragmentation
2. coalescence
3. remodelling