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Hoppenfeld Ankle/Foot Palpation
Palpation landmarks for the ankle/foot as described by Hoppenfeld
27
Medical
Graduate
10/07/2009

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Term
1st metatarsal
Definition
Palpable on ball of foot. Metatarsophalangeal joint is most frequently involved in gout and bunions.
Term
Navicular
Definition
Move proximally along medial border of foot, next large bony prominence is navicular tubercle.
Term
Head of Talus
Definition
Medial side immediately proximal to navicular, midway between medial malleolus and navicular tubercle. Invert/evert forefoot - motion between talus and navicular is palpable.
Term
Medial Malleous
Definition
From head of talus probe proximally to Medial Malleous
Term
Calcaneus
Definition
Proximal lateral border of foot.
Term
Lateral Malleolus
Definition
Located at distal end of fibula extends further distally and is more posterior than the medial malleolus.
Term
Metatarsals 2-5
Definition
Move laterally and palpate each by placing thumb on plantar surface and index finger on dorsal surface.
Term
Metatarsal Heads
Definition
Move laterally and palpate each by placing thumb on plantar surface and index finger on dorsal surface. Arch makes first and fifth heads more prominent.
Term
Cuboid
Definition
Proximal to styloid process of fifth metatarsal.
Term
1st Metatarsal Head
Definition
From calcaneus palpate distally along medial arch, if you press firmly you can feel the 2 sesamoid bones that lie within the flexor hallucis brevis tendon. Sesamoids distribute WB pressure and provide a mechanical advantage for the flexor tendon of the great toe, esp at toe off.
Term
Deltoid Ligament
Definition
Just inferior to the medial malleolus.
Term
TDH
Definition
soft tissue depression between medial malleolus and Achilles tendon. (tibialis posterior, flexor digitorum longus, artery (posterior tibial), nerve (tibial), flexor hallucis longus.
Term
Flexor Digitorum Longus
Definition
Lies just behind the tibialis posterior tendon, to palpate have patient flex toes against resistance and feel motion immediately behind the post tib just above medial malleolus.
Term
Flexor Hallisus Longus
Definition
Lies on posterior aspect of ankle joint deep to other muscles and CANNOT BE PALPATED.
Term
Posterior Tibial Artery
Definition
Lies between tendons of FDL and FHL, to palpate press gently into the soft tissue space behind the tibialis posterior and FDL tendons with the foot relaxed, NWB, and tendons on a slack.
Term
Tibialis Anterior
Definition
Most prominent and medial of TDH. To palpate have patient dorsiflex and invert, palpate from ankle joint distally onto medial aspect of base of 1st metatarsal and the first cuneiform bones and prosimally. Palpate muscle belly proximally on lateral side of tibial shaft.
Term
Extensor Hallisus Longus
Definition
Immediately lateral to tibialis anterior tendon and is prominent with big toe extension. Palpate along dorsum of foot to insertion into base of distal phalanx of big toe.
Term
Extensor Digitorum Longus
Definition
Lies lateral to EHL. Palpate with toes extended where it crosses ankle joint and distal to ankle where it divides into four parts.
Term
Dorsal Pedal Artery
Definition
Lies between the EHL and EDL tendons. Is absent 12-15% of time.
Term
Anterior Talofibular Ligament
Definition
First of 3 lateral collateral ligaments to stress and sprain with inversion and plantar flexion. Area of tendon is most easily palpated in the sinus tarsi. Ligament itself IS NOT DISTEINCTLY PALPABLE – if sprained generally palpable swelling and tenderness.
Term
Peroneals
Definition
Have patient actively evert and plantar flex foot, tendons pass just behind the lateral malleolus, as pass calcaneus they are separated by the peroneal tubercle. Palpate brevis to insertion on the styloid process.
Term
Retrocalcaneal Bursa
Definition
Lies between the anterior surface of the tendon of Achilles and the bare posterior superior angle of the calcaneus. Locate by pinching the soft tissue anterior to the Achilles tendon.
Term
Calcaneal Bursa
Definition
Lies between the insertion of the Achilles tendon and the overlying skin. Locate by lifting the skin posterior to the tendon – the bursa lies directly between your fingers.
Term
Hammer Toes
Definition
Hyperextension of the metatarsophalangeal and distal interphalangeal joint; flexion of proximal interphalangeal joint. Second toe most usually affected.
Term
Claw Toes
Definition
Hyperextension of the metatarsophalangeal joints; flexion of the proximal and distal interphalangeal joints.
Term
Corns
Definition
Soft found between toes due to moisture; hard in areas of excessive pressure.
Term
Toenails
Definition
Medial and lateral aspect of great toe involved where anterior corners of nail dig into surrounding skin.
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