ch14: lower leg, ank, foot cond Flashcards
(30 cards)
hallux rigidus
- degenerative arthritis in the first MTP jnt
s/s - tenderness
- enlarged first MTP
- loss of motion
hallux valgus
- sever valgus deformity of the big toe
- can dev bunion
s/s - asymptomatic
- pain over MTP
- 2nd map more weight bear
- diff wearing shoes
claw vs hammer vs mallet toe
claw= MTP jnt ext, DIP and PIP felxion
Hammer= MTP jnt ext, PIP flex, DIP ext
mallet= MTP and PIP neutral, DIP flex
metatarsalgia
- rel to participation in sport, age, arthritic disease, gout, diabetes
s/s:
- constant overloading of the transverse lig leads to flattening of transverse arch
- callus formation
- pain in metatarsal region
- gradual onset in intensity and duration
retrocalcaneal bursitis
cause: external pressure from a constrictive heel cup, coupled w/ excessive pronation or a varus hindfoot
- swelling, erythema and irritation of the retrocalcaneal bursa
s/s
-POP
- skin thickening
- pain with AROM PF
acute compartment syndrome
- inc pressure within a limited or nonyielding space compromises the local venous pressure and obstructs the neuromuscular network
- direct blow to anterolat aspect of tibia or tibial fx
- hx of trauma,
- excessive exercise
- vascular injury
- prolonged externally applied pressure
s/s of acute compartment syndrome
- inc severe pain and swelling out of proportion to clinical situation
- firm mass
- tight skin
- loss of sensation
- diminished dorsals pedis pulse
turf toe vs reverse turf toe
turf toe = hyperextension, p! plantar surface
reverse= hyper flexion, pain in dorsal aspect
deg of ankle sprains
1st= pain, swelling anterolat aspect, point tenderness over ATFL, no laxity w/ stress test
2nd= tearing or popping sensation felt on the lateral aspect, pain and swelling on anterolateral and inf lat malleolus, POP over ATFL and CFL, +ve ant drawer and talar tilt
3rd= tearing popping, diffuse swelling, very painful or absent pain, +ve ant drawer and taller tilt
subtler sprain
- CFL, inf extensor retinaculum, lat talocalcaneal lig, cervical lig, interosseous lig
- DF and supination
s/s - ankle turning inward
- uncomfy walking on uneven surface
- ant drawer -ve unless ankle instability
- diagnose with stress radiographs
management
- strengthen perineal, proprio
peroneal tendinopathies
- less common
- MOI- forceful passive DF
- retinaculum gives away - tendons slips forward over lat malleolus
s/s - cracking sensation
- intense pain
- inability to walk
- swelling
- tender
post tibialis tendon dysfunction
- loss of support of the spring, deltoid and talocalcaneal interosseous lig, talonavicular capsule, plantar fascia
- common cause of flat foot
stages of post tibias tendon dysfunction
stage 1= pain and swelling along the course of the tendon pain/tenderness behind medial malleolus, discomfort in longitudinal arch, flatfoot deformity minimal
stage2= unable to perform a single heel raise, weakness in the PF and inversion, tendon is enlarged, elongated, flatfoot w/ collapsed arch
stage 3= unable to perform a single heel raise and amore severe flatfoot
achilles tendon disorder
- foot malalignement and biomehanical faults, hyper pronation of foot
- tendinosis - cyst
- rupture - 30-50y/o,
1-2 inch prox to distal attachment, pop in post ank
plantar fasciitis
- most common hindfoot prob in runners
- pes cavus/planus
- dec pF strength
- dec PF flex
- prolonged pronation
- chronic= entrapment of the first branch of the lat plantar n.
medial tibial stress syndrome
- periostitis along the posteromedial border
- usually in the distal 3rd
- coleus, flexor digitorum longus, tip post
- excessive pronation of the foot
- changes in training
exertion compartment syndrome
- exercise induced pain and swelling that is relieved by rest
- ant and deep post compartment most affacted
s/s - tight
- cramp like or squeeze ache
- sens of fullness
- affects both legs
plantar interdigital neuroma
- trauma or repetitive stress caused by tight-fitted shoes or pronated feet lead to pressure on plantar digital nerves
- btw 3-4th metatarsals
- pain improves when activity stoped or shoe removed
tarsal. tunnel syndrome
- post tibial nerve or one of its branches becomes constricted beneath the fibrous roof of the flexor retinaculum of the foot
- causes: ganglion, curiosities, lipomas, tenosynovitis, fibrosis
s/s - NTB around med malleolus radiation to sole and heel, DF and ER and EV inc pain
sural nerve entrapment
numbness and dec temp along dorsolateral aspect of foot
freiberg disease
- painful avascular necrosis of the second or third metatarsal head
- 14-18 y/o idol before closure of the epiphysis
- diffuse pain in forefoot
sever disease
- 7-10 y/o
- associated w/ growth spurts, dec heel cord, h/s flex
- apophyseal plates is vertically oriented, susceptible to shearing stresses from gastroch
non critical vs critical stress fx
noncritical= medial tibia, fibula, 2-4 metatarsal
critical = high rate of non-union
- ant tibia
- med malleolus
- talus
- navicular
- 5th metatarsal
- sesamoids
