Lower Extremity Pathologies

Question 1

Diabetes Mellitus

Answer 1

Type I: Failure of pancreas to produce enough insulin
Type II: Insulin resistance, cells fail to respond to insulin properly

Orthoses: Extra depth shoes, therapeutic inserts

Question 2

Venous Insufficiency

Answer 2

Veins have trouble sending blood from leg back to the heart

Orthoses: Compression garments

Question 3

Deep Vein Thrombosis

Answer 3

Formation of blood clot/thrombus within deep vein (predominantly of the leg)
Can lead to pulmonary embolism which is life threatening

Orthoses: Antiembolism hose (TED) or graduated compression garments

Question 4

Limb Length Discrepancy

Answer 4

Common with total hip arthroplasty (27-50% of cases)
32% of population has minor LLD

Orthoses: Heel lift, good arch support

Question 5

Chondromalacia Patella

Answer 5

Inflammation of the underside of patella & softening of the cartilage which is a natural shock absorber
Affects young individuals in sports / overworking of the knees

Orthoses: Patella tracking brace (PTB), soft knee orthosis with patella stabilizer

Question 6

Patellar Subluxation Syndrome

Answer 6

Patellar instability, unstable kneecap
patella repeatedly subluxates / places strain on medial restraints & excessive stress/ tension on patellofemoral joint

Orthoses: Patella tracking brace (PTB), soft knee orthosis or patella stabilizer

Question 7

Osteoarthritis

Answer 7

Most commonly in knees/hips and on one side of the body

Orthoses: OA unloader knee orthosis

Question 8

Osgood Schlatter’s

Answer 8

Disease that is inflammation of patella ligament at tibial tuberosity
Painful lump just below the knee & most often in young adults

Orthoses: Patella band, soft knee orthosis with patella band

Question 9

ACL Insufficiency

Answer 9

Important internal stabilizer of the knee, restrains hyperextension

Orthoses: Soft hinged knee orthosis, functional knee orthosis

Question 10

PCL insufficiency

Answer 10

Restrains hyperflexion

Orthoses: Soft hinged knee orthosis, functional knee orthosis

Question 11

MCL Insufficiency

Answer 11

Results from valgus force on the knee, most commonly injured ligament

Orthoses: Soft hinged knee orthosis, functional knee orthosis

Question 12

Meniscus Tear

Answer 12

Among most common knee injuries
Athletes especially in contact sports are most at risk
Tear in different ways depending on location of tear

Orthoses: Soft hinged knee orthosis, functional knee orthosis, knee immobilizer, post-op knee ROM orthosis

Question 13

Sprains

Answer 13

Injury to ligament (bone to bone connection)
Caused by falling, twisting that forces joint out of normal position causing overstretching of ligaments

Orthoses: Soft knee brace with or without hinges, ASO

Question 14

Strains

Answer 14

Injury to muscle or tendon (muscle to bone connection)
Twisting or pulling of a muscle or tendon

Orthoses: Soft knee brace with or without hinge

Question 15

Bursitis

Answer 15

Inflammation of one or more bursa - small synovial fluid sac in the body

Orthoses: soft knee brace with or without hinges, Ankle stabilizing orthosis

Question 16

Tendonitis

Answer 16

Overuse of tendon
Acute tendon injuries that are accompanied by inflammation.

Orthoses: Soft knee brace with or without hinge, ASO

Question 17

Plantar Fasciitis

Answer 17

Irritation and swelling w/ presence of extra immune cells in the fascia of the plantar surface of the foot.

Orthoses: Gel heel cap, horseshoe heel pad, accommodative foot orthosis

Question 18

Heel Spur (Osteophyte)

Answer 18

Small bony growth or collection of growths on the plantar or posterior aspect of the calcaneous

Orthoses: Gel heel cap, horseshoe heel pad, accommodative foot orthosis

Question 19

Ulcers

Answer 19

Wounds or open sores that will not heal or keep returning

Orthoses: Extra depth shoes, therapeutic inserts, surgical shoe

Question 20

Posterior Tibial Tendon Dysfunction (PTTD)

Answer 20

Caused by changes in the tendon that impairs the ability to support the arch of the foot - resulting in flattening of the foot

Orthoses: Prefab UCBL, AFOs, Prefab arch support

Question 21

Peripheral Neuropathy

Answer 21

Damage/ disease affecting nerves and sensation, movement, gland or organ function. Causes numbness to touch, vibrations, reduced positional sense - poor coordination and balance

Orthoses: Extra depth shoes, therapeutic inserts

Question 22

Achilles Tendon Rupture

Answer 22

Most commonly injured after sudden plantar or dorsiflexion of the ankle outside of normal ROM

Orthoses: CAM walker

Question 23

Fractures of the foot

Answer 23

Metatarsal or phalangeal fracture is painful but rarely disabling

Orthoses: CAM walker