Ankle & Leg Pathologies

Question 1

Closed-packed position

Answer 1

Point in joint’s ROM at which its bones are maximally congruent; most stable position of a joint.

Question 2

Peripheral Vascular Disease

Answer 2

Swelling in foot and ankle

= associated with individuals with diabetes

Question 3

STRESS TEST
Anterior Drawer Test

Positive

Answer 3

talus slides anterior from under the ankle mortise compared with the opposite side.
Possible “clunk: as talus subluxates & relocates

Tests for anterior talofibular ligament (ATF) instability

Question 4

STRESS TEST
Inversion Stress Test (Talar Tilt)

Positive

Answer 4

Talus tilts or gaps excessively compared with uninjured side; pain is produced

Tests for calcaneofibular ligament instability

Question 5

STRESS TEST
Eversion Stress Test

Positive

Answer 5

Talus tilts or gaps excessively compared to uninjured side; pain described in motion

Tests for deltoid ligament instability, especially tibiocalcaneal ligament

Question 6

STRESS TEST
External Rotation Test (Kleiger’s Test)

Positive

Answer 6

DELTOID: medial joint pain; possible displacement of talus away from medial malleolus

SYNDESMOSIS: pain in anterolateral ankle at site of distal tibiofibular syndesmosis

Tests for injury to deltoid ligament cause by rotational stress or injury to distal tibiofibular syndesmosis

Question 7

JOINT PLAY
Subtalar

Positive

Answer 7

Increased or decreased medial or lateral translation of the talus relative to the opposite side.

Amount of medial and lateral movement at subtalar joint.

Question 8

JOINT PLAY

Cotton Test

Answer 8

Increased lateral translation of the talus relative to the opposite foot

Assesses amount of lateral translation of the talus within ankle mortise

Question 9

JOINT PLAY

Distal tibiofibular joint play

Answer 9

Pain arising from syndesmosis or increased motion relative to unilateral side

Identify anterior posterior instability of distal tibiofibular syndesmosis

Question 10

Least stable position for ankle complex

Answer 10

Open-packed position

Question 11

Talar or Tibial chondral lesion (osteochondral defect)

Answer 11

Caused by combo of inversion, plantarflexion, and talar rotation that compress the superior medial articulating cartilage of talus against tibia

Question 12

Squeeze Test

Answer 12

Pain is elicited, especially when it is away from compressed area

Identify fibular fractures or syndesmosis sprains

Question 13

Maison-neuve fracture

Answer 13

spiral fracture of the proximal one-third of the fibula with concurrent disruption of the distal tibiofibular syndesmosis.

Question 14

Pott’s Fracture

Answer 14

bimalleolar fracture

Question 15

Os Trigonum Injury

Answer 15

Formed when Stieda’s process separates from talus

Question 16

Os Trigonum syndrome (talar compression syndrome)

Answer 16

1. inflammation of posterior joint
2. inflammation of ligaments surrounding the os trigonum
3. fracture of os trigonum
4. pathology involving the Stieda’s process

Question 17

Os Trigonum Fracture

Answer 17

sudden onset of pain after forced plantarflexion or dorsiflexion

Question 18

Progressive degeneration of tendon

Answer 18

Peritendinitis -> Tendinosis -> Tendon rupture

Question 19

Thompson Test

Answer 19

When calf is squeezed, foot does not plantarflex

Tests for Achilles tendon rupture

Question 20

MTSS

Answer 20

Medial Tibial Stress Syndrome

Periostitis at posterior medial border of the tibia
Results in overuse (running)

Question 21

Bump Test for Leg Stress Fractures

Positive

Answer 21

Pain emanating from fracture of calcaneus, talus, fibula, or tibia

Identify stress fractures of the leg or talus.

Question 22

Compartment Syndromes

Answer 22

Increased pressure (exceeding capillary perfusion pressure) within compartment, resulting in local tissues not receiving an adequate supply of oxygen.

Question 23

Chronic exertional compartment syndrome (CCS)

AKA: recurrent compartment syndrome/intermittent claudication

Answer 23

Occurs secondary to anatomic abnormalities obstructing blood flow in exercising muscles.

DO NOT APPLY PRESSURE!

Question 24

Compartment Syndrome

Signs & Symptoms

Answer 24

Pain
Pallor (redness)
Pulselessness
Paresthesia
Paralysis

Question 25

Deep Vein Thrombosis (DVT)

Answer 25

blood clot

Question 26

Homans’ sign

Answer 26

exacerbation of symptoms with the knee flexed and forceful, passive dorsiflexion of ankle

Detect DVT