Midfoot pain

Question 1

What are some key questions to ask the patient

Answer 1

-Onset of symptoms, sudden or gradual
-Is the pain more medial or lateral
-Is there instability when you land on your foot
-Is the pain on the dorsum of plantar aspect of foot
-When relief the symptoms such as footwear

Question 2

What are some important structures to consider?

Answer 2

-MLA
-Navicular tuberosity
-Foot pronation or supination during gait
-Lisfranc joint
-Cuboid and base of fifth MT

Question 3

What further question would you ask if the pain is chronic?

Answer 3

-Underlying conditions of diabetes, arthritis or gout
-Any long-standing structural problems they have had

Question 4

What is the N spot?

Answer 4

-Between tibialis anterior and flexor hallucis longus
-Pain in this area indicate a navicular stress fracture

Question 5

What are some potential diagnosis for medial arch, navicular prominence or N-spot?

Answer 5

-Navicular stress fracture (N-Spot)
-Tendinopathy
-Acessory navicular (prominent navicular)
-longitudinal arch sprain
-Fibromatosis

Question 6

What are some potential diagnosis for pain at navicular prominence with unilateral loss of static or dynamic long arch?

Answer 6

-spring ligament
-Partial or complete tear of tibialis posterior tendon

Question 7

What the midfoot pain is more dorsum?

Answer 7

-Arthritis of tarsal metatarsal joint
-Lisfranc joint sprain
-Ganglion cyst
-consider extensor tendinopathy

Question 8

Potential diagnosis of lateral midfoot pain?

Answer 8

-Cuboid sublux
-peroneus longus or brevis tendinopathy
-Enthesopathy or avulsion fracture