Presentation Flashcards
Presentation - Achilles Tendinitis
Morning pain is the hallmark symptom. Symptoms are typically localized to the tendon. May have swelling, asymmetry, painful palpation, decreased ROM, tendon thickening, and pain with increased activity.
Presentation - Achilles Tenovaginitis
Will see painful palpation. The patient will have pain with doing heel raises. The tendon may appear swollen or thickened and crepitus may be present.
Presentation - Calcaneus Apophysitis
Not always considered a primary source of heel pain. Pain is most located at the medial process of the calcaneus during weight-bearing activities and made worse with increased tension from increased activity in the gastroc/soleus complex.
Presentation - Peroneus Lesion
Will have pain, swelling at lateral lower leg. Pain will be exacerbated by rising onto the balls of the feet, running, cutting, jogging, or walking on uneven surfaces. Will see decreased strength and ROM.
Presentation - Flexor Digitorum Lesion
This will appear with weakness in toe flexion and decreased ROM. Patient may show decreased balance, change in static or dynamic foot, impaired subtalar mobility, and pain behind medial malleolus and medial longitudinal arch.
Presentation - Tibialis Posterior Lesion
Will experience pain on the inside of the foot, ankle, and lower leg. May be unable to perform heel raise in standing. May have flattened arch with visible swelling or thickening of medial lower leg and ankle.
Presentation - Flexor Hallucis Lesion
Will experience pain in the medial region of ankle which travels down to big toe. Pain may be exacerbated by strong or repetitive contractions from stranding on balls of the feet, running, jumping, hopping. Patients may experience pain worse in the morning. There will be a worsening of symptoms with continued activity and pain with palpation.
Presentation - Achilles Tendon Rupture
Patients report feeling a pop or snap followed by immediate sharp pain in the back of ankle. Examiner may feel swelling around tendon and a palpable gap where tear exists. Standing on the toes will be impossible.
Presentation - S1 Root Lesion
Often presents with pain in low back described as sharp, dull, stabbing, shooting, or burning. This may go down the leg in S1 distribution. Weakness may be present in muscles innervated by S1 (posterior compartment – gastrosoleous complex). Alteration of sensation may occur in S1 dermatome distribution which is at lateral foot, posterior heel up lateral lower leg. Achilles tendon reflex may also be affected.
Presentation - Tibialis Anterior Lesion
Presents with pain at the front of the shin
Presentation - Extensor Hallucis Lesion
Will see pain at the top of the foot. Pain will be worse with running and relieved with rest. May have some diffuse swelling over the top of the foot. If the toes are flexed, this will increase pain. There will be pain with active dorsiflexion and extension of the big toe.
Presentation - Extensor Digitorum Lesion
You will see pain at the top of the foot. Pain will be worse with running and relieved with rest. May have some diffuse swelling over the top of the foot. If the toes are flexed, this will increase pain. There will be pain with active dorsiflexion and extension of the toes.
Presentation - Tenosynovitis of Dorsiflexors
You will see swelling on top of foot or ankle. There will be pain with active dorsiflexion. Pain will be worse with activity and decrease with rest. Patient will have tenderness to the touch and will have painful MMT and decreased ROM.
Presentation - Myosynovitis of Tibialis Anterior
Will present with painful DF at the front of the ankle but painless RROM of big toe and outer toe extension. Tenderness is felt at the anterior tibial tendon. Crepitus may be felt with slight movement.
