Lower leg, ankle, foot assessment Flashcards
pain with first step in the morning? dx
plantar fasciitis or Achilles tendonitis
acute hyperextension of the 1st MTP? dx
turf toe
insidious onset of 1st MTP pain and swelling? dx
gout
numbness and tingling in the foot? dx
tarsal tunnel syndrome
Morton’s neuroma
ottawa ankle rules - tenderness/pain areas (4)
post. lateral malleolus
post. medial malleolus
base of 5th metatarsal
navicular
ecchymosis?
bruising
CPG grade I ankle sprain
negative ant drawer and talar tilt tests
lose less than 5 deg of motion
minimal swelling
CPG grade II ankle sprain
positive anterior drawer test
negative talar tilt test
lose 5-10 ROM
swelling 0.5-2cm
CPG grade III ankle sprain
positive ant drawer and talar tilt tests
decreased rom >10
swelling greater than 2cm
CPG ankle sprain recovery prognosis
grade I - 1 week
grade II - 2 weeks
grade III - 1-2 months
5 factors increasing risk of acute lateral ankle sprain
previous sprain don't use external support do not properly warm up lack DF ROM do not participate in balance and proprioception training
2 main foot and ankle outcome measures
FAAM - foot and ankle ability measure
LEFS - lower extremity functional scale
strongest ligament between the talus and calcaneus (subtalar joint)
cervical ligament
major ligament of the medial ankle
deltoid ligament
major ligaments of the lateral ankle
PTFL
ATFL
Calcaneofibular ligament
most commonly sprained ligament of the lateral ankle
Anterior talofibular
resting position of the talocrural joint
10 deg PF
close packed position of the talocrural and distal tibiofibular joints
max DF
which extends more inferiorly, medial or lateral malleolus?
lateral
close packed position of the midfoot and forefoot joints
supination
close packed position of the MTP and IP joints
full extension
very important exercises to perform following acute lateral ankle sprain
balance + proprioception
1st digit complication resulting in calluses and painful bunions
hallux valgus
___% of hallux valgus cases are caused by metatarsus primus varus, in which the intermetatarsal angle is increased to more than 15°
80%
Formation of an interdigital neuroma as a result of injury to one of the digital nerves.
Morton’s metatarsalgia
what is syndactyly
webbing of the digits
DF ROM
20
PF ROM
50
inversion ROM
30
eversion ROM
15
rear foot inversion and eversion ROM
5
very good special test for Achilles tendon tears
Thompson
good test for identifying anterolateral ankle impingement
impingement sign
good test for ruling out tarsal tunnel syndrome
triple compression test
special test for plantar fasciitis
windlass test
Clinical prediction rule for anterolateral ankle impingement - 5/6 must be present
Anterolateral ankle joint tenderness Anterolateral ankle joint swelling Pain on forced dorsiflexion and eversion Pain on affected side with single leg squat Pain with activities Absence of ankle instability
measurement in the navicular drop test that is considered abnormal
> 10mm
normal range for medial longitudinal arch height
120-150
normal tibial torsion by viewing line between medial and lateral malleoli
12-18
normal amount of toes to see during the too many toes sign
2 1/2
3 test cluster for lateral ligament sprain
ant drawer
talar tilt
star excursion
Best outcome measure for plantar fasciitis
FAAM - foot and ankle ability measure
