Foot/Ankle 2

Question 1

a positive too many toes sign can indicate pathology of either what tendon or ligament?

Answer 1

posterior tibial tendon or spring ligament

Question 2

the posterior process of the talus consists of what two tubercles?

Answer 2

lateral and medial tubercle

Question 3

an os navicular can interfere with the attachment of what tendon to the navicular?

Answer 3

posterior tibial tendon

Question 4

what is a hammertoe deformity?

Answer 4

flexion deformity of the DIP joint

Question 5

what is a mallet toe deformity?

Answer 5

hyperextension of the MTPJ and fixed flexion of the PIP and DIP joints

Question 6

t/f a plantar calcaneal enthesophyte is normally the cause of pain in plantar fasciitis

Answer 6

false

Question 7

a night splint in what direction of ROM is indicated for plantar fasciitis?

Answer 7

dorsiflexion

Question 8

what is a positive Severs test?

Answer 8

heel pain aggravated by heel rise

Question 9

a 10 yo male athlete has heel pain and XR demonstrates fragmentation, sclerosis. what is the diagnosis?

Answer 9

Severs disease

Question 10

what is the treatment for Severs disease?

Answer 10

rest, activity modification, stretching and strengthening

Question 11

an athlete has pain at the plantar surface of the great toe MTPJ. XR reveals proximal migration of the sesamoids. what is the diagnosis?

Answer 11

plantar plate fupture

Question 12

a patient with turf toe should wear a walking boot until when?

Answer 12

pain free

Question 13

what is the hallmark radiographic finding of hallux rigidus?

Answer 13

dorsal exostosis of the first metatarsal

Question 14

what surgical procedure is appropriate if conservative management fails for hallux rigidus to benefit the running athlete by improving dorsiflexion movement?

Answer 14

proximal phalanx osteotomy

Question 15

how would you initially treat hallux rigidus conservatively?

Answer 15

shoe modification, nsaids, orthotics, intraarticular steroids

Question 16

which condition is characterized by overload of the metatarsal head leading to repetitive stress and attritional tear of the MTPJ plantar plate?

Answer 16

lesser MTPJ instability

Question 17

which metatarsal head is the most common site of lesser MTPJ instability?

Answer 17

second MT head

Question 18

what are the major 3 components of initial treatment of lesser MTPJ instability?

Answer 18

rest, splint toe, and stiff soled shoes

Question 19

what is the most hypovascular portion of the navicular?

Answer 19

central one third

Question 20

what imaging modality is the gold standard for navicular stress fracture?

Answer 20

CT

Question 21

what is the initial treatment for navicular stress fracture?

Answer 21

short leg cast immobilization for 6-8 weeks

Question 22

what two criteria should be met prior to a patient with calcaneal stress fracture being allowed to participate in gradual return to activity?

Answer 22

symptoms abate and when radiographs document healing

Question 23

in what specific portion of the bone does a Jones fracture occur?

Answer 23

metaphyseal - diaphyseal junction

Question 24

what is the term for stress fracture of the fifth metatarsal?

Answer 24

Jones fracture

Question 25

if you treat a Jones fracture non operatively, what length of time should you immobilize in cast and then using a walking boot, respectively?

Answer 25

4-6 weeks cast followed by 4-6 weeks walking boot

Question 26

at which joint is metatarsophalangeal joint synovitis most common:

Answer 26

second MTPJ

Question 27

a patient complains of medial arch pain and pain with resisted inversion. On exam, they have difficulty with one leg heel raise. what is the most likely diagnosis?

Answer 27

posterior tibial tendinopathy

Question 28

t/f direct tenderness at the plantar MTPJ of the great toe and pain with resisted plantarflexion can indicate sesamoid pathology

Answer 28

true

Question 29

if conservative treatment for sesamoiditis with activity modification, rest, nsaids, orthotics, walking boot fails you should perform CT or MRI to rule out presence of what?

Answer 29

stress fracture

Question 30

what are the two key initial components of management of sesamoid fracture?

Answer 30

immobilization and protected weight bearing with cast or boot

Question 31

what joint of the ankle allows eversion/inversion of the ankle?

Answer 31

subtalar joint

Question 32

how should a non displaced or stress fracture of the talus initially be managed?

Answer 32

6 weeks of non weightbearing followed by a walking boot

Question 33

what two bones are connected by the Lisfranc ligament?

Answer 33

medial cuneiform and 2nd MT base

Question 34

how is a lisfranc sprain managed?

Answer 34

CAM boot

Question 35

how is a non displaced lisfranc injury with ligament disruption managed?

Answer 35

non weightbearing cast

Question 36

how is a displaced lisfranc ligament injury managed?

Answer 36

ORIF

Question 37

how is an avulsion fracture at the base of the fifth metatarsal typically treated?

Answer 37

non surgically / conservatively

Question 38

how are second through fourth metatarsal stress fractures usually generally managed?

Answer 38

conservatively - cessation of weightbearing activities, modified rest and immobilization prn for pain control

Question 39

other than open fracture, what is the only other time surgery is typically required for phalangeal fracture of the foot?

Answer 39

intraarticular fracture of the great toe with displacement

Question 40

what is the treatment for non displaced phalangeal fracture?

Answer 40

buddy tape and hard soled shoe

Question 41

which tendon runs just inferior to the sustenaculum tali?

Answer 41

FHL

Question 42

which metatarsal interspace is most commonly affected by interdigital neuroma?

Answer 42

third

Question 43

t/f taping should not be performed on an acute ankle sprain

Answer 43

true