Term
| Which ligament is the most important medial stabilizer? |
|
Definition
Deltoid Ligament - composed of anterior tibiotalar
tibionavicular
tibiocalcaneal
posterior tibiotalar |
|
|
Term
| What is the "too many toes" sign? What does it indicate? |
|
Definition
From a posterior view of the pt standing in front of you, you see more than 1 toe on the lateral sides.
Indicates some type of pathology |
|
|
Term
| If a pt presents with flat feet (lost of longitudinl arch) and foot or knee pain, what condition should you suspect? |
|
Definition
|
|
Term
| What ligament failure is involved in Pes Planus? |
|
Definition
| Failure of PTT (Posterior Tib Tendon) |
|
|
Term
| How is Pes Planus assessed on radiographs? |
|
Definition
| Standing lateral and standing AP to assess heel angle |
|
|
Term
| What is the treatment for congenital pes planus? |
|
Definition
PT – arch support
Ortho or Podiatry - surgery |
|
|
Term
| What is the treatment for adult onset pes planus? |
|
Definition
PT consult – ROM exercise
No arch supports (do not help)
NSAIDS
Ortho or Podiatry (Surgery) if ADLs are affected or If skin breakdown or ulceration is present |
|
|
Term
| What is Pes Cavus almost always related to? |
|
Definition
| Some type of nervous disorder (Polio, burns, compartment syndrome) |
|
|
Term
| If a pt presents with elevated longitudinal arch, with fixed platar flexion of the forefoot, what condition do you suspect? |
|
Definition
|
|
Term
| What is the treatment for pes cavus? |
|
Definition
|
|
Term
| What is the MC injury in sports? Which mechanism is the MC? |
|
Definition
| Ankle Sprains; Inversion sprain |
|
|
Term
| What are the Ottowa Rules used to assess? |
|
Definition
| The need to x-ray an ankle sprain or not |
|
|
Term
| What are the Ottawa Rules? |
|
Definition
The distal 6 cm of the posterior edge of the tibia
Tip of the medial malleolus
The distal 6 cm of the posterior edge of the fibula
Tip of the lateral malleolus
Inability to bear weight both immediately and in the emergency department for four steps. |
|
|
Term
| Which grade of ankle sprain is described as partial tear of anterior talofibular ligament? |
|
Definition
|
|
Term
| Which grade of ankle sprain is described as partial to complete tear of anterior talofibular ligament & partial tear calcaneofibular ligament? |
|
Definition
|
|
Term
| Which grade of ankle sprain is described as complete rupture of the anterior talofibular ligament & calcaneofibular ligament? |
|
Definition
|
|
Term
| Which grade of ankle sprain warrants surgical repair? |
|
Definition
| Grade III (Grade II if mortis is disrupted) |
|
|
Term
| What is the MC cause of Ankle Fractures/Dislocations? |
|
Definition
| History trauma – fall, misstep or sports injury |
|
|
Term
| If a patient presents post-trauma with obvious pain and swelling of the ankle, and deformity and inability to bear weight, what condition do you suspect? |
|
Definition
| Ankle Fracture/Dislocation |
|
|
Term
| What are the indications for surgery with ankle fractures? |
|
Definition
Surgery for ankle instability or poor patient compliance
Open fracture/dislocation |
|
|
Term
| When is casting of an ankle dislocation warranted? |
|
Definition
| If there are NO fractures, you can cast |
|
|
Term
| What leads to a unstable ankle? |
|
Definition
| Any disruption of mortis or syndesmosis |
|
|
Term
| If a runner presents with pain in the morning with 1st step, heel pain and tenderness on palpation, what condition should you suspect? |
|
Definition
|
|
Term
| What is the treatment for plantar fasciitis? |
|
Definition
PT – stretching and toe curls for strengthening (MOST IMPORTANT!)
NSAIDS & ice
Ortho – steroid injections |
|
|
Term
| If a pt presents with heel pain w/walking and complains of a constant stone in their shoe, what condition should you suspect? |
|
Definition
|
|
Term
| What is the treatment for heel spurs? |
|
Definition
NSAIDS & ice
Heel pad
PT Stretching
Ortho – injection or surgery |
|
|
Term
| If a pt presents s/p trauma from fall, with heel pain, ecchymosis as well as heel widening, what condition should you suspect? |
|
Definition
|
|
Term
| What radiographic views are used to assess a calcaneus fracture? |
|
Definition
| Plain film: AP, lateral, Broaden views (Most important) "Foot Films" |
|
|
Term
| What is the treatment for a calcaneus fracture? |
|
Definition
Ortho – surgery
Non-weight bearing until healed – min 6 wks
PT – gait walking |
|
|
Term
| If a pt has a painful toenail, swelling and discharge from the toe, what condition should you suspect? |
|
Definition
|
|
Term
| What is the MC cause of ingrown toenails? |
|
Definition
| incorrect nail trimming, cleaning nails non-sterile tools, improper fitting shoes |
|
|
Term
| What is the treatment for MILD Ingrown toenails? |
|
Definition
| warm soaks, antibiotics and correct cause |
|
|
Term
| What is the treatment for moderate ingrown toenail? |
|
Definition
|
|
Term
| What is the treatment for SEVERE or chronic Ingrown toenails? |
|
Definition
| Complete nail removal/Ablation of nail bed if chronic? |
|
|
Term
| If a pt presents with thickened, brittle, crumbly or ragged toenails that are distorted in shape, are dull with no luster or shine, what condition should you suspect? |
|
Definition
| Onchomycosis caused by Tinea Unguium |
|
|
Term
| What is the treatment for Onchomycosis? |
|
Definition
Get baseline LFT and one after 4 weeks of treatment.
Treat with Antifungal medication - Terbinafine (Lamisil) x 4 months |
|
|
Term
| What secondary condition can develop with hammer toes? |
|
Definition
|
|
Term
| What is the treatment for hammer toes? |
|
Definition
Surgery - release of ligaments
Taping of hammertoes |
|
|
Term
| Which joint(s) does hammertoe involve? |
|
Definition
|
|
Term
| Which joint(s) does clawtoe involve? |
|
Definition
| PIP and DIP or just the DIP |
|
|
Term
| What is the treatment of claw toe? |
|
Definition
|
|
Term
| When is amputation with a claw toe deformity necessary? |
|
Definition
| If skin uncontrolled breakdown of skin or osteomyelitis risk |
|
|
Term
| If a pt presents with lateral deviation of great toe with an enlarged medial eminence with pain? |
|
Definition
| Hallux Valgus and Bunions |
|
|
Term
| What is the treatment for Hallux Valgus? |
|
Definition
Conservative – braces, no heels no pointed toes
Ortho or Podiatry - Surgery |
|
|
Term
| With Hallux valgus describe the displacement of the proximal phalanges and the metatarsal head? |
|
Definition
| Metatarsal head is going medially, proximal phalange is being displaced laterally |
|
|
Term
| What is the treatment for osteoarthritis of the foot and ankle? |
|
Definition
PT consult – ROM
Decrease weight
NSAIDS
Ortho - fusion |
|
|
Term
| If a pt present with severe burning pain in their foot between the 3rd and 4th metatarsal that increases with activity, may increase with tight shoes, what condition should you suspect? |
|
Definition
|
|
Term
| What physical diagnosis test is described as pt lie supine, examiner grabs around metatarsal head and squeezes heads together? What is a positive test? |
|
Definition
Morton's Test
resulting in pain between 3rd & 4th metatarsal head |
|
|
Term
| What is a treatment for Morton's Neuroma? |
|
Definition
| Ortho – steroid injection |
|
|
Term
| How is a Lisfranc Injury that is less than 2 mm dislocation, how is it treated? |
|
Definition
| the fracture can be managed with casting for 6 weeks, the patient's injured limb cannot bear weight during this period (6 wks) |
|
|
Term
| What is a major concern with a lisfranc injury? |
|
Definition
| Development of compartment syndrome |
|
|
Term
| If a patient present post MVA and has foot pain and tenderness at the tarsometatarsal joint, what condition do you suspect? |
|
Definition
|
|
Term
| If a pt presents with foot pain, and Dislocation of the mid-tarsal (talonavicular and calcaneocuboid) joints of the foot, what condition is suspected? |
|
Definition
| Chopart’s Fracture-Dislocation |
|
|
Term
| How is a severe Lisfranc fracture treated? |
|
Definition
|
|
Term
| How is a Chopart’s Fracture-Dislocation treated? |
|
Definition
| Open reduction w/ internal fixation |
|
|
Term
| Which fracture is known as Oblique, comminuted fx of distal tibia that extends through the tibiotalar articular surface and usually occurs s/p trauma? |
|
Definition
|
|
Term
| What are the major complications of a Pilon Fracture? |
|
Definition
| arthritis, skin breakdown |
|
|
Term
| How is a pilon fracture treated? |
|
Definition
Ortho Surgery -
1) External Fixation (wait for skin to heal) then Internally fix
2) Amputation |
|
|
Term
| What is important when reducing pilon fractures? |
|
Definition
Maintain length of bone
Protect articular surface |
|
|
Term
| What is the rule with surgical fixation of metatarsal fractures? |
|
Definition
| If 1st and 5th metatarsal are intact and 2-4 are not displaced to much, you do not need to fix. |
|
|
Term
| What is a fracture of the 5th metatarsal commonly called? |
|
Definition
|
|
Term
| If a dancer presents with pain and tenderness over the head of 5th metatarsal after a inversion trauma, what condition do you suspect? |
|
Definition
|
|
Term
| How is a Jone's fracture treated if it is not intraarticular? |
|
Definition
| Crutches & non weight bearing short leg cast for 6 weeks |
|
|
Term
| If a pt present with history of kicking a door when they got up to use the bathroom, and their 4th toe is painful, swollen and they c/o difficulty walking and wearing shoes, what condition should you suspect? |
|
Definition
|
|
Term
| How is a toe fracture treated? |
|
Definition
Buddy tape
Stiff sole shoes
NSAIDS
If displaced or comminuted – ortho surgery |
|
|
Term
If patient presents with Heat insensitivity in the foot
Loss of sensation in the foot , Swelling of the foot and ankle, Dislocated foot joints, Weak foot muscles, Foot ulcers and Calluses, what condition should you suspect? |
|
Definition
|
|
Term
| What is the common name for Charcot’s Disease? |
|
Definition
Rocker bottom foot
Boat bottom foot |
|
|
Term
| What condition are Charcot’s Disease associated with? |
|
Definition
Chronic hyperglycemia
Diabetes mellitus
Originally Syphillis |
|
|
Term
| What is the treatment for charcot's disease that has no risk of osteomyelitis or skin breakdown? |
|
Definition
| Surgical rebuilding of foot |
|
|
Term
| In which pts is achilles tendonitis MC? |
|
Definition
|
|
Term
| What is the treatment for achilles tendinitis? |
|
Definition
Rest – short leg walking cast
NSAIDS
PT consult
1 cm heel lift
Ortho – steroid injections |
|
|
Term
| If a pt can't stand on tip toes on affected side and has a + Thompson test, what condition should you suspect? |
|
Definition
|
|
Term
| What is the treatment for a Ruptured Achilles Tendon? |
|
Definition
|
|
Term
| Which physical diagnosis test is described as pt laying prone, squeezing calf causes plantar flex or none if test is positive? |
|
Definition
|
|
