foot stuff Flashcards
what is hallux valgus
also known as bunions
valgus angulation of the big toe
tendons pull on the bones making it worse
sesamoid bones sublux
what causes halux valgus
genetics
foot wear
what are risk factors for halux valgus
female
footwear
how does halux valgus present
usually bilateral
visible valgus deformity
big toe rubs on second toe
weight gets distributed to metatarsals by patient to reduce pain
metatarsalgia
pressure symptoms from shoes
examine foot when it is bearing weight and not bearing weight
what investigation could you do for hallux valgus
X-ray to look for bony change and deformity
how do you manage hallux valgus
shoe wear modification activity modification orthotics analgesia surgery
what is plantar fasciitis
fibroblast hypertrophy of skin
disorganised and dysfunctional blood vessels and collagen causes avascularity
can’t make ECM to remodel and repair
chronic and degenerative change
what causes plantar fasciitis
idiopathic
athletes with high intensity training
foot and lower limb rotational deformities
tight gastro soleus complex
what are risk factors for planter fasciitis
obesity
occupations involving prolonged standing - policeman’s foot
how does plantar fasciitis present
start up pain
pain is at origin of plantar fascia
usually lasts 2+ years
what investigations can you do for plantar fasciitis
x-ray
US
MRI
how would you manage plantar fasciitis
rest alter training lose weight stretching ice physio orthotics NSAIDs corticosteroid injections night splinting
what is Achilles tendinosis
degenerative disease of tendon
can be due to many things
what can cause achilles tendinosis
associated with tears in collagen and cysts
bursitis
inflammation of paratendon
what are risk factors for achilles tendinosis
overuse paratendinopathy male 30-40 diabetic obese steroids
how does achilles tendinosis present
pain on use
can rupture
recurrent episodes
what are clinical signs of achilles tendinosis
simmonds test
diffuse swelling
can sometimes feel a gap in the tendon
dangle test
what investigations could you do for achilles tendinosis
MRI
US
how can you manage achilles tendinosis
weight loss stretching activity modification shoe wear modification shockwave treatment release and debridement of tendon
what is morton’s neuroma
digital nerve is repeatedly damaged between the metatarsals and causes swelling and pain
what are risk factors for morton’s neuroma
female aged 40-60
heeled shoes
how does morton’s neuroma present
neuralgic pain usually in 2nd and third toes
altered sensation in webspace
mulders click
how do you treat morton’s neuroma
steroid injection
surgical excision
what is charcots foot
extreme damage to joints of foot
foot becoems very deformed
lack of proprioception and protective pain sensation and problems with neurovascular supply causes this
fragmentation, coalescence and remodelling
what can cause charcots foot
diabetes
syphilis
neuropathy
how does charcots foot present
no pain in early stages very deformed foot swollen erythematous bones can fuse large bulge at sole can have ulcers
what investigations could you do for charcots foot
MRI
x-ray
how would you manage charcots foot
prevention with tight diabetic control and high index of suspicion
immobilisation
surgery to reconstruct
amputation
