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Diagnostic Imaging 2 > Foot and ankle > Flashcards

Foot and ankle Flashcards

(40 cards)

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1
Q

Ottawa ankle rules

A

Pain in malleolar zone
AND

-bone pain in posterior edge or tip of med or lat malleolus
AND/OR
-can’t bear weight immediately and in clinic

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2
Q

Ottawa foot rules

A

Pain in midfoot zone
AND

-bone pain in base of 5th MT or navicular
AND/OR
-can’t bear weight immediately and in clinic

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3
Q

standard and stress views of the ankle

A

AP
AP oblique (mortise view)
Lateral
Oblique

inversion stress
eversion stress

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4
Q

standard and stress views of the foot

A

AP
oblique
lateral

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5
Q

AP view of the ankle is good for:

A
  • distal tib and fib
  • medial and lateral malleoli

Notice:

  • lateral tibia superimposed over fibula
  • parallel talar dome and distal tib
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6
Q

AP ankle view outline

A
  • distal tibia
  • distal fibula
  • talar dome
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7
Q

AP oblique (mortise view) is good for:

A

pt position: shank is IR ~15-20 deg

  • mortise
  • mortise width is normally 3-4 mm
  • angulations or translations of talus in mortise
  • minimal superimposition of lateral tibia and fibula
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8
Q

mortise view outline

A
  • distal tibia
  • distal fibula
  • talar dome
  • mortise width and constancy of width
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9
Q

lateral view of the ankle good for:

A

pt position: ankle should be close to neutral (medial side up)

  • anterior and posterior tibia
  • positions of hindfoot and mid foot
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10
Q

lateral ankle view outline

A

distal tibia

  • anterior tubercle
  • posterior malleolus

distal fibula

calcaneus
talus
navicular
3 cuneiforms
cuboid

tasral sinus

tuberosity of the 5th MT
sesamoid bones of the 1st ray

subtalar and midtarsal joints

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11
Q

oblique view of the ankle is good for:

A

pt position: IR ~45 deg

  • distal fibula
  • lateral malleolus
  • distal tibiofibular joint
  • talofibular joint
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12
Q

oblique view of ankle outline

A
  • fibula and tibia
  • lateral malleolus
  • talar dome
  • distal tibiofibular joint
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13
Q

AP view of the foot good for:

A

DORSOPLANAR view

Can be weight bearing or non

  • phalanges
  • metatarsals
  • midfoot
  • 1st MT angle
  • hallux valgus angle
  • Chopart joint (calcaneocuboid & talonavicular)
  • Lisfranc joint (tarsal and metatarsal)
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14
Q

AP foot view outline

A 
phalanges
metatarsals
midfoot
1-2 intermetatarsal angle
hallux valgus angle
chopart joint
lisfranc joint
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15
Q

hallux valgus

A

weight bearing AP view of foot

1-2 intermetatarsal angle
-bisection of 1st and 2nd MT

hallux valgus angle
-bisection of 1st MT and prox phalanx

mild:
1-2 IMA = 15 deg
HVA= >40 deg

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16
Q

oblique view of the foot

A
  • non WBing
  • lateral foot lifted ~45 deg
  • notice less superimposition of tarsals and metatarsals
  • first and second cuneiform are superimposed
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17
Q

oblique foot view outline

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A

1-5 metatarsals

  • head, shaft, base of 1st
  • tuberosity of 5th

1-5 prox phalanges

sesamoid bones

cuboid and 3rd cuneiform

navicular, talus, calcaneus

18
Q

lateral view of the foot

Study These Flashcards
A
  • weightbearing (for longitudinal arch measures)
  • non WBing (trauma)
  • usually neutral position
19
Q

lateral foot view outline

Study These Flashcards
A

distal tibia and fibula
talus, calcaneus, navicular, cuboid
subtalar, midtarsal (chopart) and tarsometatarsal (lisfranc) joints

20
Q

lateral view of the foot- lines and angles

Study These Flashcards
A 
***important to know if the foot is loaded or not
Boehler angle (calcaneal fx)

talometatarsal angle

calcaneal inclination

21
Q

Boehler angle (calcaneal fx)

Study These Flashcards
A

line joining anterior and posterior calcaneal facets

line posterior facet and superior posterior process

normal= 25-40 deg

22
Q

Talometatarsal angle

Study These Flashcards
A

line bisecting the 1st MT
line bisecting the talus

normal= 0-10 deg

23
Q

calcaneal inclination

Study These Flashcards
A

line joining inferior limit of distal calcaneal facet and inferior distal tuberosity
plane of support

normal= 20-30

24
Q

inversion or eversion stress view

Study These Flashcards
A

AP views
stress manually applied
-looking for excessive tilting of talus in mortise

abnormal= >10 deg
pt will get bone bruising, swelling on contralateral side

25
sesamoid view
plantar dorsal view position of sesamoids in groove normal: ride of bone (leaving two grooves for sesamoids) hallus valgus= medial migration of sesamoids. the worse the hallux valgus, the more stress on the EHL, EDL, FHL stress everything medially, dislocated sesamoids medially
26
malleolar fractures
UNI-MALLEOLAR FX: either med or lat BI-MALLEOLAR FX: both med and lat TRI-MALLEOLAR FX: med, lat and posterior tibial rim (only seen in a lateral view-posterior edge of tibial rim)
27
calcaneal fractures
Boehler Angle usually fall from height most fractured bone in the foot!
28
Boehler angle
used to evaluate the angular relationship of the talus and calcaneus in the presence of trauma normal= 25-40 degrees less=calcaneal fractures 1 line from the posterior aspect of the subtalar joint to the anterior process of the calcaneus 2nd line drawn across the posterior superior margin of the calcaneus
29
talar fractures
second most fractured bone in the foot neck fractures most common high incidence of: AVN, subtalar and ankle DJD
30
adult acquired flatfoot
most common: - women, 45-65 y/o - diabetes, Seroneg arthropathies, overweigh, smoking? many theories, but most common involves PTT
31
posterior tibialis dysfunction/rupture
lacking supination at Tst, PSw loss of dynamic control of medial longitudinal arch prolonged excessive, uncontrolled pronation eventually stretches static stabilizers PTT: goes through some dysfunction and could actually rupture tenosynovitis: only when it develops a tendon sheath bc it goes around a bony protuberance
32
stage I adult acquired flatfoot
painful synovitis of PTT, tender to palpation tendon length and function maintained, strength can be 5/5
33
stage II adult acquired flatfoot
progressive tendon dysfunction weakness and tendon lengthening flexible flatfoot develops
34
stage III adult acquired flatfoot
deformity becomes rigid stiff/arthrosis rigid flatfoot= loss of arch even when NWBing, not a laxity
35
stage IV adult acquired flatfoot
tibiotalar valgus arthritic changes progress
36
rigid flatfoot
loss of medial arch even if they are NWBing, not a laxity
37
flexible flatfoot
loss of medial arch only when WBing
38
adult acquired flatfoot conservative treatment
stages I and II - orthosis - inflammation reduction - stretching - high rep PF training
39
adult acquired flatfoot surgical treatment
transfer of FDL to navicula ( think about balance of toe flex/ext) implant plug to limit subtalar eversion (subtalar arthroeisis) calcaneal osteotomy -make PF invert during late stance osteotomy= rotational- long bone- cut through, rotate it and then fix it arthrodesis
40
arthrodesis
often done: - to correct hyperpronation/painful flexible flatfoot - severe subtalar DJD - trauma talonavicular calcaneal cuboid subtalar

Diagnostic Imaging 2 (6 decks)

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