Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK > orthopaedic foot conditions > Flashcards

orthopaedic foot conditions Flashcards

1
Q

What are the treatment options for orthopaedic foot conditions

A

analgesia
show wear change
activity changes
weight loss
physiotherapy
orthotics e.g insoles and bracing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the indication of surgery in orthopaedic foot conditions

A

When the non surgical treatment fails

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is seen in hallux valgus (bunions)

A

medial deviation of the first ray and vagus agulation of the big toe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the causes of hallux valgus

A

genetic
foot wear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which gender is hallux valgus more common in

A

female due to men wearing more accomodating foot wear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the symptoms of hallux valgus

A

pressure symptoms from shoe wear

Pain from crossing over of the toes

metatarsalgia - pain in the metatarsals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is used to diagnose hallux valgus

A

Xray - determine severity of the bony deformity and exclude associated degenerative changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the management of hallux valgus

A

shoe wear modification

orthotics to offload pressure and correct the deformity

activity modification

analgesia

Operative - if non-op fails :
Release the lateral soft tissues
osteotomy of the first metatarsal - breaking the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is hallux rigidus

A

Stiff big toe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What causes hallux rigidus

A

osteoarthritis of the first metatarsal-phalangeal joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the main symptom of hallux rigidus

A

Pain at extreme dorsiflexion but usually asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is hallux rigidus diagnosed

A

clinically and radiographs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the management of hallux rigidus

A

activity modification

Shoe wear with rigid sole - very helpful option

analgesia

Surgical treatment :
Cheilectomy - if the pain is only during dorsiflexion of the big toe and the rest of the toe is fine
Arthrodesis
Arthroplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a cheilectomy

A

Remove the dorsal osteophytes - provides better range of dorsiflexion with less pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is 1st MTPJ fusion (arthrodesis)

A

The surface of the joint is debrided - fixation is then used to allow bone to cross over the joint
This is the gold standard surgical treatment of hallux rigidus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is hammer toe

A

Flexion of the proximal inter-phalangeal joint and dorsiflexion of the metacarpal-phalangeal joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is claw toe

A

flexion of the proximal and distal inter-phalangeal joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is mallet toe

A

flexion of the distal inter-phalangeal joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the causes of lesser toe deformities

A

imbalance between flexors and extensors

shoe wear

rheumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the symptoms of lesser toe deformities

A

deformities

Pain from the dorsum and plantar sides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the treatment of lesser toe deformities

A

Non surgical:
Activity modification
Shoe wear - flat shoes with high toe box
Orthotic insoles

Surgical:
Flexor to extensor transfer - dividing the flexor tendon of the toe and moving it to the extensor
fusion of interphalangeal joint
release metatarsophalangeal joint
shortening osteotomy of metatarsal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is mortons neuroma

A

Inflammation and swelling with severe pain and numbness

common plantar nerve is traumatised and new nerve sprouts grow with fibrous tissue around them and there is a painful lump which presses on them called a mortons neuroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Who is mortons neuroma more common in

A

40-60 year old females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the symptoms of mortons neuroma

A

affects the 3rd and 2nd webspace/ toes

neuralgic burning sensation in the toes

Intermittent

altered sensation in the webspace

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the best way to diagnose mortons neuroma

A

Mulder’s click - pain should localise between the metatarsal heads - if there is a lump on the nerve, if you press onto it, moving it dorsally and then squeeze it over the metatarsal head, it will make a clicking which is very painful

Ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the management of mortons neuroma

A

Injection for small lesions

Surgery:
excision of the lesion including part of the normal nerve which can lead to numbness and pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is metatarsalgia

A

A symptom and not a diagnosis

Pain coming from the forefoot - the digits and the metatarsals

28
Q

What is rheumatoid forefoot

A

Pain
Hallux valgus
hammer toe
pressure areas with bursitis
caused by rheumatoid arthritis

29
Q

What is the treatment of rheumatoid forefoot

A

Shoe wear to accomodate the deformity
orthotics
reduction in activity or a change in activity

Operative
Gold standards:
1st metatarsalphalangeal joint arthrodesis (fusion)
2-5th toe excision arthroplasty

30
Q

Where do dorsal foot ganglia come from

A

joints or the tendon sheath

31
Q

What causes dorsal foot ganglia

A

underlying arthritis
underlying tendon pathology

32
Q

What are the symptoms of dorsal foot ganglia

A

Pain from pressure due to the shoes that are worn
Pain from underlying problem

33
Q
A
34
Q

What is the treatment of dorsal foot ganglia

A

aspiration of the ganglia - can confirm diagnosis as well

Surgical - excision - has a high rate of occurance

35
Q

What kind of arthritis can affect the midfoot

A

Post traumatic arthritis
osteoarthritis
rheumatoid arthritis

36
Q

What is the treatment of midfoot arthritis

A

activity modification
shoe wear modification
orthotics

Xray guided injections

Surgical:
Fusion of a joint

37
Q

What is plantar fibromatosis

A

(Ledderhose disease)

Considered as the dupuytren’s of the foot

Causes lumps in the sole of the foot and is progressive

38
Q

What is the treatment of plantar fibromatosis

A

Show wear management
orthotics

Surgical:
Excision - high recurrence rate

combination radiotherapy and surgery - low recurrence but high complication risk

39
Q

What is achilles tendonitis/tendinosis

A

Degenerative condition with little inflammation of the achilles tendon

40
Q

Who does paratendinopathy commonly affect

A

athletic individuals
30-40 years old
male 2:1 female

41
Q

Who is commonly affected in tendonopathy

A

non-athletic
>40 Years
obese
steroid use
diabetics

42
Q

What are the symptoms of achilles tendinopathy

A

Pain during exercise
pain after exercise
recurrent episodes
difficulty fitting shoes due to the rubbing feeling - suggests it is insertional

43
Q

How is achilles tendonopathy diagnosed

A

Ultrasound
MRI - shows the severity

44
Q

What is the achilles rupture test and describe it

A

Simmonds test - calf squeeze test - squeeze the calf and if the achilles tendon is normal the foot will move plantar flexion wise but if the achilles is ruptured, there will be no movement

45
Q

What is the treatment of achilles tendonopathy

A

Activity modification
weight loss
shoe wear modification
physiotherapy
extra-corporeal shockwave treatment- vibrates tissue and stimulates fibrous tissue to form and heal
Immobilisation

Surgical treatment -
Gastrocnemius recession - lengthening the gastrocnemius

release and debridement of tendon

46
Q

What is plantar fasciitis

A

Can’t make extra cellular matrix which is required for repair and remodelling

Chronic degenerative change, fibroblast hypertrophy, absent inflammatory cells, disorganised and dysfunctional blood vessels and collagen, avascularity

47
Q

What are the symptoms of plantar fasciitis

A

Pain first thing in the morning

Pain on weight bearing after rest

Pain at the origin of plantar fascia

Commonly lasts for over 2 years

48
Q

How is plantar fasciitis diagnosed

A

Mainly clinical
ultrasound and MRI can be used

Xrays can be used but are not that helpful

49
Q

What is the treatment of plantar fasciitis

A

rest
activity modification
stretching of the achilles
ice
NSAIDs
orthoses - heal pads
physiotherapy
weight loss
corticosteroid injections - short tem
night splinting

Extracorporeal shockwave therapy can be done as a third line treatment

50
Q

Who most commonly gets ankle arthritis

A

46 year old is the average age

commonly post traumatic

51
Q

What are the symptoms of ankle arthritis

A

pain and stiffness of the ankle joint

52
Q

How is ankle arthritis diagnosed

A

clinical
radiographs
CT scan

53
Q

What is the treatment of ankle arthritis

A

weight loss
activity modification
analgesics
physiotherapy
steroid injections

Surgical treatment:

Arthrodesis (fusion) is the gold standard - screws are passed through the ankle joint to fuse it

Ankle replacement - can fail after few years

54
Q

What happens when the tibialis posterior tendon malfunction

A

planovalgus foot - flat foot occurs in people who normally have a good arch

55
Q

How is tibialis posterior tendon dysfunction diagnosed

A

Clinical - double and single heel raise - checking if the patient can stand on the tip toes

MRI to assess the tendon

56
Q

What is the management of tibialis posterior tendon dysfunction

A

Orthotics - resting the tibialis posterior with medial arch support

Surgical:
reconstruction of tendon

triple fusion - subtalar, talonavicular and calcaneocuboid joints are fused

57
Q

What are the foot conditions that can occur in diabetic foot

A

Ulceration and charcot foot

58
Q

What is the cause of diabetic foot ulcer

A

Diabetic neuropathy - patient is unaware of trauma to the foot

59
Q

What are features of diabetic neuropathy

A

Decreased sweating and sebum production so there is dry cracked skin

60
Q

What is the treatment of diabetic foot ulcer

A

Prevention of the ulcers is the best method but treatment is hard once an ulcer is formed

Diabetic contro
stop smoking
reduce pressure where the ulcer is by using splints, shoes and weight bearing changes

Surgical treatment:
Improve vascular supply

debridement of ulcer and get samples for microbiology

correct any deformity which is causing increased pressure on the ulcer

amputation

61
Q

What is the cause of charcot neuroarthropathy

A

any cause of neuropathy - diabetes is the most common

Syphillis

62
Q

What happens in charcot neuropathy

A

Neurotraumatic - Lack of proprioception and protective pain sensation tso the joints are being put through excessive movements which cause damage

Neurovascular - abnormal autonomic nervous system results in increased vascular supply and bone resorptio

63
Q

What are the 3 stages of bone destruction in charcot neuropathy

A

fragmentation
coalescence
remodelling

64
Q

How is charcot neuropathy diagnosed

A

Clinically - Consider any diabetic with acute swollen erythematous foot with neuropathy

Radiographs
MRI scans

65
Q

How is charcot neuroarthropathy treated

A

Prevention is best

Immobilisation

Surgical:
Correct the deformity as it could lead to increased pressure in an area which could cause ulceration and infection which would then lead to amputation

MSK (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions