Ankle Exam

Question 1

Traumatic incident causing forced inversion or eversion

Answer 1

Ankle sprain
Fracture
Peroneal nerve injury- if inversion

Question 2

Trauma to ankle that included tibial rotation on a planted foot

Answer 2

syndesmotic sprain

Question 3

tenderness of anterior shin- increasing pain with wb

Answer 3

Tibial stress syndrome

Question 4

Traumatic event resulting in inability to PF

Answer 4

Achilles tendon rupture

Question 5

Pain with stretch of calf muscles during gain

Toe push off

Answer 5

Achilles tendonitis

Sever’s disease

Question 6

Pain at heel with first few steps out of bed and after prolonged walking

Answer 6

Plantar fascitiis

Question 7

Pain or paresthesia in plantar surface of foot

Answer 7

Tarsal tunnel syndrome
sciatica
lumbar radiculopathy

Question 8

Pain on plantar surface between 3rd and 4th metatarsals

May be worse with shoes vs barefoot

Answer 8

Mortons Neuroma

Metatarsaliga

Question 9

Ottawa Ankle Rules for X Ray

Answer 9

Need one if:
Pain at posterior edge of lat malleolus
Pain at poster edge of med malleolus
Pain at 5th metatarsal
Pain at navicular bone
or
inability to bear weight after immediately after injury or during exam

Question 10

How will the shoes look with a drop foot

Answer 10

Scuffed at toes

Question 11

How will the shoes loo with a hard foot striker

Answer 11

Increased wear on the heel

Question 12

How to do the figure of eight edema measuring

Answer 12

leg in open chain

Question 13

What is the toe position in Claw toes

Answer 13

MTP hyperextension
PIP flexed

Associated with pes cavus, spina bifida

Failure of interossei and lumbricals

Question 14

What is the toe position in Hammer toes

Answer 14

MTP hyperextended
PIP flexed
DIP hyperextended

usually only seen in the 2nd toe and common with Hallux Valgus, RA and poor fitting shoes

Question 15

How do you find Subtalar neutral

Answer 15

Pt prone
If evaluating right ankle use Left hand to palpate hollows over the neck of the talus on the anterior side
Then with right hand grasp 4/5 metatarsal and rock back and forth
Then when talus is bulged equally on med and lat side= subtalar neurtral

Question 16

How to find rearfoot leg orientation

Answer 16

Measure angle from distal, posterior leg and midline of posterior calcaneus

Normal= lines are parallel to slight varus

Question 17

How to find forefoot to rearfoot orientation

Answer 17

Pt prone- with foot off table
Find subtalar neutral
Compare line of metatarsal heads to a line bisecting the rearfoot

Normal= 10-12 Degrees

Forefoot varus= inversion of forefoot away from neurtral
Forefoot valgus= everted forefoot position

Question 18

How to find the first Ray position

Answer 18

Pt prone or sitting
Grasp 1st and 2nd MT- and align them with one another

1st ray should move into DF
2nd should move into PF
to be even

Question 19

Where do you find the dorsal pedal artery

Answer 19

Lateral to EHL and between 2nd and 3rd cuneiforms