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My MSK > Lower Limb Conditions- FOOT AND ANKLE > Flashcards

Lower Limb Conditions- FOOT AND ANKLE Flashcards

1
Q

What is hallux valgus

A

Deformity of the big toe, medial deviation of the first metatarsal and lateral deviation of the toe

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2
Q

Risk factors of hallux valgus

A

Familiar tendency, RA, inflammatory arthropathies, NM diseases, CTDs, increased joint laxity

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3
Q

Symptoms of hallux valgus

A

Pain, bunion formation, shoe difficulties, transfer metatarsalgia, lesser toe impingement, ulceration

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4
Q

Treatment of hallux valgus

A

Shoe modifications, paddling, surgery (sarf/akin osteotomy)

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5
Q

What is hallux rigidus

A

Osteoarthritis of the first metatarsal phalangeal joint

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6
Q

Treatment of hallux rigidus

A

Stiff sole shoes (metal bar), removal of osteophytes, gold standard= arthrodesis

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7
Q

What is Morton’s Neuroma

A

Degenerative fibrosis of the digital nerve near to its bifurcation

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8
Q

Pathogenesis of Morton’s Neuroma

A

Repeated trauma to the ligaments over the nerve causes inflammation, swelling and neuroma formation

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9
Q

Causes of Morton’s Neuroma

A

Can be caused by wearing high heels and is often linked to bursitis

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10
Q

Symptoms of Morton’s Neuroma

A

Burning and tingling in toes (usually 3rd and 4th), metatarsalgia (walking on a pebble)

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11
Q

Diagnosis of Morton’s Neuroma

A

Mulder’s click test, loss of sensation in affected web space

US= swollen nerve

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12
Q

Treatment of Morton’s Neuroma

A

Offloading insole, metatarsal pad, steroid anaesthetic injections, surgery (excision)

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13
Q

Causes of Tendo-achilles tendinosis

A

Repetitive strain due to sports causing frequent micro trauma with not enough time for collagen repair resulting in loss of fibre alignment and degeneration of the tendon

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14
Q

Risk factors for Tendo-achilles tendinosis

A

Overtraining, quinolone antibiotics, RA, inflammatory arthropathies, gout

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15
Q

Symptoms for tendo-achilles tendinosis

A

Pain, morning stiffness, eases with heat + walking

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16
Q

Treatment for tendo-achilles tendinosis

A

Usually self-limiting, NO STEROI DINJECTIONS, analgesia, NSAIDS, shockwave therapy, orthotics/heel raise/splints/boots/physio, surgery= tendon decompression

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17
Q

Causes + Symptoms of Tendo-achilles rupture

A

Sudden deceleration with resisted calf muscle contraction causing a sudden pain, unable to weight bear, weak plantar flexion

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18
Q

Diagnosis of Tendo-achilles rupture

A

Palpable painful gap, Simmonds test (positive calf squeeze, no plantar flexion of foot when squeezed)

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19
Q

What is claw toe

A

Hyperextension at MTP joint, hyeprflexion at DIP and PIP joints

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20
Q

What is hammer toe

A

Hyperextension at MTP joint, hyeprflexion at PIP and hypertension at DIP

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21
Q

Where is the tibialis posterior tendon located

A

Posterior to the medial malleolus and inserts on the navicular tuberosity

22
Q

Function of tibialis posterior tendon

A

Stabilises and elevates the medial arch

23
Q

Symptoms of tibialis posterior dysfunction

A

Pain and swelling posterior to medial malleolus + can change the shape of the foot

24
Q

Treatment of tibialis posterior dysfunction

A

Physiotherapy, insoles to support arch, orthoses, splint to prevent rupture

25
Q

What is pes cavus and what causes it

A

Abnormally high arch of the foot can be idiopathic or neurological (HSMN, CP, spina bifida, polio, club foot)

26
Q

What is plantar fasciitis

A

Inflammation of the plantar fascia

27
Q

Cause of plantar fasciitis

A

Repetitive physical overload

28
Q

RF of plantar fasciitis

A

Excessive weight, diabetes, seronegative arthropathy, abnormal footshape

29
Q

Symptoms of plantar fasciitis

A

Strat up pain after rest, worse after exercises, swelling of plantar medial aspect of heel

30
Q

Diagnosis of plantar fasciitis

A

Tinel’s test positive for Baxter’s nerve

31
Q

Treatment of plantar fasciitis

A

Self-limiting- can need rest, stretching exercises, NSAIDS, night splints, taping, heel cup/medial arch supports, physiotherapy

32
Q

Differentiate between the two types of planovalgus

A

Flexible- normal variant in children, can be familial or idiopathic, due to ligamentous laxity or gastrosoleus complex tightness, positive jack test (big toe dorsiflexion forms arch)
Fixed- bony abnormality, tarsal coalition can require surgery

33
Q

Who gets metatarsal stress fractures and in what toes

A

Dancers, runners, soldiers in 2nd then 3rd metatarsal

34
Q

When might metatarsal stress fracture be seen on XR

A

After 3 weeks when callus has formed

35
Q

Treatment of metatarsal stress fracture

A

6-12 weeks rest in a rigid soled boot

36
Q

Causes of ankle sprains

A

Inversion twisting on a planted foot

37
Q

Ligaments most affected in ankle sprain

A

Anterior talofibular and calcaneofibular (AFTL and CFL)

38
Q

Describe Weber Classification

A

Describes ankle fractures in relation to the syndesmosis between the tibia and fibula
A- below
B-on
C-above

39
Q

Treatment of ankle sprains

A

RICE, physio, surgery= Brostrum Gould

40
Q

Describe stable ankle fractures

A

Distal fibular fractures with no medial malleolar fractures or deltoid ligament rupture, treated with walking cast/splint for 6 weeks

41
Q

Describe unstable ankle fractures

A

Distal fibular fractures with deltoid ligament rupture treated with ORIF

42
Q

What is talar shift

A

Increased space within the ankle mortise, can lead to post traumatic OA requires reduction and internal fixation

43
Q

What is talar tilt

A

Bottom of the tibia and top of the talus are non-parallel

44
Q

What does talar shift + talar tilt indicate

A

Deltoid ligament rupture unless medial malleolar fracture

45
Q

What is a midfoot/lisfranc fracture

A

Fracture + dislocation of the base of the second metatarsal, causes dislocation of other metatarsal and no ligament holds the bone in place

46
Q

Symptoms of lisfranc fracture

A

Very swollen, bruised foot, unable to weight bear

47
Q

Treatment of lisfranc fracture

A

Open/closed reduction + fixation with screws

48
Q

Where are metatarsal fractures common

A

Base of 5th metatarsal

49
Q

Who is clubfoot more common in

A

Boys

50
Q

What is clubfoot

A

Congenital structural deformity in foot formed in 7th week gestation, in utero abnormal alignment of joints between talus, calcaneus and navicular –> contractors of the soft tissue –> ankle equines

51
Q

Treatment for clubfoot

A

Ponseti technique casts for 5-6 weeks –> tenotomy of achilles tendon –> boot and bar to prevent recurrence

My MSK (7 decks)

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