Leg, Ankle, and Foot Flashcards
What is the tibial torsion test
- Patient supine with knees flexed 90 degrees
- Examiner visualizes the axes of the knee and ankle – normally there is about
15 degrees of external rotation
Positive => 18 degrees = toe out torsion or <13 degrees = toe in torsion
what are the findings of tibial torsion test?
Tibial torsion – inward twisting of
the tibia; most common cause of in
toeing (usually around 2 years old)
what is the dorsiflexion test?
- Used when patient is unable to dorsiflex their ankle – assess whether it is
Gastrocnemius or Soleus that is causing the problem - Patient seated, examiner flexes patient’s knee and attempts to dorsiflex ankle
Positive => able to dorsiflex ankle in seated position; indicates gastrocnemius
muscle hypertonicity (bending of knee gives slack to relax muscle)
Positive => inability of ankle to dorsiflex in either position; indicates soleus
hypertonicity (because it does not cross the knee joint)
what are the findings for dorsiflexion test?
Gastrocnemius or soleus
hypertonicity or deficit
what is the Homan’s sign
- Patient lying supine
- With knee extended and leg raised to 10 degrees, forcible dorsiflex patient’s ankle
and squeeze leg
Positive => pain in calf region
what is the findings for homan’s sign?
Indicates deep vein thrombosis
what is the Thompson’s (squeeze test)
- Patient is prone
- Examiner squeezes patient’s gastrocnemius toward midline on each side
Positive => lack of plantar flexion of ankle during squeeze
what is the findings for thompson’s test
achilles tendon rupture
what is the anterior drawer test for the ankle?
- Patient is supine, feet off end of table, stabilize tibia and fibula
- Hold foot in 20 of plantar flexion and draw talus anteriorly (up) in the ankle
mortise. Repeat with ankle dorsiflexion.
Positive => excessive anterior motion or feel a “clunk”
what is the finding for anterior drawer test for the ankle?
anterior talofibular ligament damage
what is the tinel’s tap (peroneal nerve)
- Anterior tibial branch of deep peroneal nerve can be percussed in front of the
ankle - Posterior tibial nerve can be percussed as it passes behind the medial
malleolus
Positive => in both cases – tingling or paresthesia felt distally
what is the findings for tinel’s tap
used to test for compression neuropathy
what is the windlass test
Non-weight bearing
1. Passively raise toes of patient while sitting to see whether pain is elicited
2. Patient’s knee is flexed to 90 while in a non-bearing position
3. Examiner stabilizes ankle (with one hand placed just behind the first
metatarsal head) and extends the MTP joint while allowing the IP to flex
(preventing motion limitations due to short hallucis longus)
Positive => pain elicited at the end range of the MTP extension
Weight-bearing position
1. Patient stands on a step stool and positions the metatarsal of heads of the
foot to be tested just over the edge of the step
2. Patient is instructed to place equal weight on both feet
3. Examiner passively extends the 1st metatarsophalangeal joint while allowing
the interphalangeal joint to flex
4. Passive extension (ex. dorsiflexion) of the 1st metatarsophalangeal joint is
continued to its end range or until pain reproduced
Positive => pain elicited at the end range of the MTP extension
what are the findings for windlass test
Achieves direct stretch on plantar
aponeurosis – examine if there is
dysfunction of the plantar fascia
Aids in decision-making for
treatment of plantar fasciitis
what is the talar tilt test
- Patient is side lying with foot relaxed (lying on opposite
- Relax the gastrocnemius by having them flex their knee
- Foot is held in anatomical position above the table
- The talus is then tilted from side to side into inversion and eversion
Positive => pain or excessive movement on inversion
