foot stuff

Question 1

what is hallux valgus

Answer 1

also known as bunions
valgus angulation of the big toe
tendons pull on the bones making it worse
sesamoid bones sublux

Question 2

what causes halux valgus

Answer 2

genetics

foot wear

Question 3

what are risk factors for halux valgus

Answer 3

female

footwear

Question 4

how does halux valgus present

Answer 4

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

Question 5

what investigation could you do for hallux valgus

Answer 5

X-ray to look for bony change and deformity

Question 6

how do you manage hallux valgus

Answer 6

shoe wear modification
activity modification
orthotics
analgesia 
surgery

Question 7

what is plantar fasciitis

Answer 7

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

Question 8

what causes plantar fasciitis

Answer 8

idiopathic
athletes with high intensity training
foot and lower limb rotational deformities
tight gastro soleus complex

Question 9

what are risk factors for planter fasciitis

Answer 9

obesity

occupations involving prolonged standing - policeman’s foot

Question 10

how does plantar fasciitis present

Answer 10

start up pain
pain is at origin of plantar fascia
usually lasts 2+ years

Question 11

what investigations can you do for plantar fasciitis

Answer 11

x-ray
US
MRI

Question 12

how would you manage plantar fasciitis

Answer 12

rest
alter training
lose weight
stretching
ice
physio
orthotics
NSAIDs
corticosteroid injections
night splinting

Question 13

what is Achilles tendinosis

Answer 13

degenerative disease of tendon

can be due to many things

Question 14

what can cause achilles tendinosis

Answer 14

associated with tears in collagen and cysts
bursitis
inflammation of paratendon

Question 15

what are risk factors for achilles tendinosis

Answer 15

overuse
paratendinopathy
male 30-40
diabetic
obese
steroids

Question 16

how does achilles tendinosis present

Answer 16

pain on use
can rupture
recurrent episodes

Question 17

what are clinical signs of achilles tendinosis

Answer 17

simmonds test
diffuse swelling
can sometimes feel a gap in the tendon
dangle test

Question 18

what investigations could you do for achilles tendinosis

Answer 18

MRI

US

Question 19

how can you manage achilles tendinosis

Answer 19

weight loss
stretching
activity modification
shoe wear modification 
shockwave treatment 
release and debridement of tendon

Question 20

what is morton’s neuroma

Answer 20

digital nerve is repeatedly damaged between the metatarsals and causes swelling and pain

Question 21

what are risk factors for morton’s neuroma

Answer 21

female aged 40-60

heeled shoes

Question 22

how does morton’s neuroma present

Answer 22

neuralgic pain usually in 2nd and third toes
altered sensation in webspace
mulders click

Question 23

how do you treat morton’s neuroma

Answer 23

steroid injection

surgical excision

Question 24

what is charcots foot

Answer 24

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

Question 25

what can cause charcots foot

Answer 25

diabetes
syphilis
neuropathy

Question 26

how does charcots foot present

Answer 26

no pain in early stages
very deformed foot
swollen 
erythematous 
bones can fuse
large bulge at sole
can have ulcers

Question 27

what investigations could you do for charcots foot

Answer 27

MRI

x-ray

Question 28

how would you manage charcots foot

Answer 28

prevention with tight diabetic control and high index of suspicion
immobilisation
surgery to reconstruct
amputation