Hindfoot problems

Question 1

What are the symptoms of achilles tendinosis?

Answer 1

Pain, esp during or following exercise
Recurrent episodes
Difficulty fitting shoes
Rupture

Question 2

What are the causes of achilles tendinopathy?

Answer 2

Degeneration

Overuse

Question 3

What is achilles tendinopathy associated with?

Answer 3

Over 40
Obesity
Steroids
Diabetes

Question 4

What is achilles paratendinopathy associated with?

Answer 4

30-40 year olds

Athletic populations

Question 5

How is achilles tendinosis diagnosed?

Answer 5

Clinical- tenderness and test for rupture

Investigations- US, MRI

Question 6

What is the clinical test for achilles rupture?

Answer 6

Simmonds test

Question 7

What is the non operative treatment of achilles tendinosis?

Answer 7

Activity modification
Weight loss
Shoe wear
Physio
Extracorporeal shock wave treatment
Immobilisation

Question 8

What shoes are used in achilles tendinosis?

Answer 8

Slight heel

Question 9

What are the operative managements of achilles tendinosis?

Answer 9

Gastrocnemius resection

Release and debridement of tendon

Question 10

What is plantar fasciitis associated with?

Answer 10

Athletes
Obesity
Prolonged standing
Foot/lower limb rotation deformities
Tight gastro-coleus complex

Question 11

What is plantar fasciitis in athletes associated with?

Answer 11

High intensity or rapid increase in training

Running in poorly padded shoes or on hard surfaces

Question 12

What are the signs and symptoms of plantar fasciitis?

Answer 12

Pain at origin of plantar fascia- first thing in morning, weight bearing after rest
Long lasting

Question 13

What is the differential diagnosis for plantar fasciitis?

Answer 13

Nerve entrapment syndromes
Arthritis
Calcaneal pathology

Question 14

How is plantar fasciitis diagnosed?

Answer 14

Clinically

Occasionally- X-rays, US, MRI

Question 15

What are the treatments for plantar fasciitis?

Answer 15

Rest, change training
Stretching
Ice
NSAIDs
Orthoses
Physio
Weight loss
Corticosteroid injections
Night splinting

Question 16

What are the new/3rd line treatments of plantar fasciitis?

Answer 16

Extracorporeal shock wave therapy
Topaz plasma collation
Nitric oxide
Platelet rich plasma
Endoscopic/open surgery

Question 17

Who is ankle arthritis seen in?

Answer 17

Over 40s

Commonly post traumatic

Question 18

What are the signs and symptoms of ankle arthritis?

Answer 18

Pain

Stiffness

Question 19

How is ankle arthritis diagnosed?

Answer 19

CLinical
Xray
CT

Question 20

What is the non operative management of ankle arthritis?

Answer 20

Weight loss
Activity modification
Analgesia
Physio
Steroid injections

Question 21

What are the operative treatments of ankle arthritis?

Answer 21

Arthrodesis- gold standard

Joint replacement

Question 22

What does posterior tibial tendon dysfunction cause?

Answer 22

Acquired flat foot planovalgus

Question 23

What are the signs and symptoms of posterior tibial tendon dysfunction?

Answer 23

Lateral or medial pain
Flatt foot
Inward rolling ankle
Turning out of toes

Question 24

How is posterior tibial tendon dysfunction diagnosed?

Answer 24

Largely clinical

MRI to assess tendon

Question 25

What are the treatment options of posterior tibial tendon dysfunction?

Answer 25

Orthotics

Surgery- reconstruction of tendon, triple fusion