MSK- foot and ankle pathology

Question 1

What is Morton’s Neuroma?

Answer 1

thickening of the tissue that surrounds the digital nerve that leads from the ball of the foot between the third and fourth toes

Question 2

how does mortons neuroma present?

Answer 2

• Tingling, numbness or an unpleasant feeling in the toes.
• Burning pain in the ball of the foot that may radiate into the toes and intensifies with activity.
• The feeling that something is inside the ball of the foot.
• The feeling that a pebble or marble is in the shoe or a sock is bunched up.

Question 3

What is plantar fibromatosis?

Answer 3

fusiform nodular thickenings of the plantar fascia in the mid foot

Question 4

how does flantar fibromatosis present?

Answer 4

• Patients will usually present with one or more palpable lumps or thickenings in the arch of their foot
• Not usually painful but may be symptomatic due to physical discomfort.

Question 5

Plantar fascia function?

Answer 5

• tendinous aponeurosis structure
• supports the longitudinal archs of the foot
• protects the neurovascular structures and tendons from lesions

Question 6

Plantar fascia location?

Answer 6

• originates posterior to the calcaneus in five bands that separate to involve the digital tendons
• proximal insertion, near the medial tubercle of the calcaneal tuberosity is evaluated

Question 7

plantar fascia normal thickness?

Answer 7

3-4mm

Question 8

what is plantar fascitis?

Answer 8

• painful foot condition
• causes by inflammation of insertion of the plantar fascia on the medial process of the calcaneal tuberosity
• inflammation of the thick band of tissue (also called a fascia) at the bottom of your foot that runs from your heel to your toes

Question 9

what is plantar fascitis associated with?

Answer 9

• pain
• swelling
• warmth
• redness

Question 10

risk factors of plantar fasciitis?

Answer 10

• foot arch
• obesity
• long-distant running
• tight achillies tendon
• shoes with poor support

Question 11

Achilles tendon function?

Answer 11

plantar flexion of the ankle

Question 12

achilles tendon trv and length measurement?

Answer 12

trv- 5-6mm

length- 12-15cm

Question 13

what is the largest and strongest tendon of the body?

Answer 13

achilles tendon

Question 14

achilles tendon location?

Answer 14

courses vertically downwards from its gastrocnemius and soleus origin to reach the posterior of the calcaneus, where it inserts

Question 15

what is peritendinous envelope associated with?

Answer 15

achilles tendon

Question 16

achilles tendon examined from?

Answer 16

• its myotendinous junction to the calcanear insertion

- zero fluid should be seen

Question 17

partial thickness tears

Answer 17

enlargement of the tendon ( >1 cm) with abnormally hypoechoic or anechoic areas within which correspond to the tear and associated adjacent tendinosis

Question 18

full thickness tears?

Answer 18

• often shows separation of the torn ends with a contour change of the tendon
• there is acoustic shadowing at the margins of the tear from sound beam refraction, and adjacent hypoechoic tendinosis

Question 19

tarsal tunnel syndrome?

Answer 19

compression, or squeezing, on the posterior tibial nerve that produces symptoms anywhere along the path of the nerve running from the inside of the ankle into the foot

Question 20

Os Trigonum?

Answer 20

• extra (accessory) bone that sometimes develops behind the ankle bone (talus)
  connected to the talus by a fibrous band
• presence of an os trigonum in one or both feet is congenital (present at birth)

Question 21

what is the nutcracker injury associated with?

Answer 21

os trigonum syndrome

Question 22

what is os trigonum syndrome commonly caused by?

Answer 22

repeated downward pointing of the toes -ballet dancers, soccer players