Tests

Question 1

What is the typical testing for the different kinds of osteochondrosis? (freibergs, kohlers, Osgood, LCP, severs)

Answer 1

Imaging is required to accurately determine. Damage and fragmentation of the respective structures will appear on imaging if positive.

Question 2

Common testing for a tarsal coalition?

Answer 2

First indication will be significantly reduced ROM of the STJ, especially ankle inversion. Hubscher manoeuvre, positive if MLA doesn’t move. Heel raise test, if no inversion occurs then it’s potentially positive.

Question 3

Common testing for an accessory navicular?

Answer 3

Clinical examination finding tenderness and swelling over navicular, with possible motion between AN and navicular. Radiographs are required to confirm.

Question 4

Common testing for a clubfoot?

Answer 4

Centered around physical presentation, joint positioning, and ROM. Depending on age/severity, presents with varying degrees of RF varus, ankle equinus, and FF adduction.

Question 5

Common testing for plantar fasciitis/fasciosis?

Answer 5

Ultrasound/MRI necessary to confirm structural changes to the tissue. Detailed history important in ruling out other DD’s. Palpation of the medial calcaneal tubercle and palpation of the fascia with hallux DF will produce pain.

Question 6

Common testing for plantar fibromas?

Answer 6

Palpable nodule. Imaging can confirm, as well as a tissue biopsy.

Question 7

Common testing for stress fractures?

Answer 7

Initial diagnosis difficult due to poor imaging reliability early on. Clinical tests unreliable, Percussion tests to surrounding area.

Question 8

Common testing for tarsal tunnel syndrome?

Answer 8

Percussion test over medial calcaneal nerve, but not completely reliable. Triple compression test (ankle inverted, PF, and pressure placed on post tib nerve) is valid. History necessary for ruling out others.

Question 9

Common testing for a haglund’s deformity?

Answer 9

Imaging to confirm. Must assess severity of deformity, location in sagittal plane, and position of calcaneus in WB to determine if it can contribute to calcaneal tendinopathies.

Question 10

Common testing for retrocalcaneal bursitis?

Answer 10

Two finger pinch test: medial and lateral pressure applied anteriorly to achilles insertion, most reliable/
Active resisted PF and passive DF can trigger pain.
Imaging to rule out bony structures.

Question 11

Common testing for PTTD?

Answer 11

Resisted active ankle inversion with plantarflexion. Pain or weakness is positive. Heel raise test, lack of inversion positive. Pain with palpation over post tib tendon.

Question 12

Common testing for Baxter’s nerve entrapment?

Answer 12

Tinel’s sign test. Phalen’s test (passive inversion and PF). Windlass to rule out plantar fasciitis.

Question 13

Common testing for sinus tarsi syndrome?

Answer 13

Pain over the sinus tarsi area (lateral ankle below malleolus) with end range plantar flexion and supination is typical of STS. Localized pain or discomfort over the sinus tarsi area with pronation and supination an indication.

Question 14

Common testing for peroneal tendinopathy?

Answer 14

Pain with passive stretching of the peroneals through inversion, adduction and dorsiflexion of the foot. Active resistance against this will also cause pain. Palpation of tendons will induce pain.

Question 15

Common testing for cuboid syndrome?

Answer 15

Based primarily on patients history and findings of assessment. Imaging useful for ruling other conditions out.

Question 16

Common testing for a lisfranc injury?

Answer 16

Pain with palpation of dorsal and plantar midtarsal joints. Stability of the Lisfranc joints can be assessed through passive pronation and supination of the forefoot.

Question 17

Common testing for a morton’s foot?

Answer 17

Imaging required to confirm. In the clinic, while plantar flexing the toes to reveal the MTPJ’s, determine if the first is shorter than the third. If yes, it’s positive.

Question 18

Common testing for a morton’s neuroma?

Answer 18

Webspace tenderness test: compression of space between toes, positive with pain and paresthesia.
Mulder’s click: compression of webspace with med/lat compression of MT’s.
Foot squeeze: medial/lateral pressure to MT’s with passive DF/PF of a toe, held for 30s.
Plantar percussion: tapping over neuroma, causing pain and paresthesia

Question 19

Common testing for MTPJ synovitis?

Answer 19

Anterior drawer: DF MT head with proximal phalanx stabilized. Palpation of affected MT head elicits pain. Reduced ROM in plantar flexion, also causing pain

Question 20

Common testing for MTPJ capsulitis?

Answer 20

Detailed patient history, pain with plantar palpation, and positive vertical stress test. Stabilize proximal MT and raise digit.

Question 21

Common testing for flexor tenosynovitis?

Answer 21

Imaging most conclusive, ultrasonography best. Active resisted plantar flexion of the affected toes can signify the involved structures.

Question 22

Common testing for sesamoiditis?

Answer 22

Pain on palpation of plantar 1st MPTJ. Pain with extension of 1st MTPJ. Reduced ROM.

Question 23

Common testing for MTSS?

Answer 23

Detailed history to determine etiology. Pain with palpation of the medial border of the tibia, in a 4-6cm area in lower third. Active DF can elicit pain.

Question 24

Common testing for PFPS?

Answer 24

Patellar tilt: supine, knee extended and full relaxed. Thumb and finger on medial and lateral border of patella. If one side sits higher than the other, indicates tilt.

Question 25

What is the purpose of the double heel raise test?

Answer 25

To determine the supinatory potential of the rear foot in cases where the RF is everted. Determine integrity of post tib tendon.

Question 26

What is the purpose of Ely’s test?

Answer 26

Determine spasticity of rectus femoris

Question 27

What is the purpose of the navicular drop test?

Answer 27

Examine for hyperpronation

Question 28

What is the purpose of Kleiger’s test?

Answer 28

Determining if there is a deltoid ligament strain, and if the syndesmosis is involved.