Foot/ankle Exam

Question 1

Ottawa Ankle rules for imaging

Answer 1

Indicated following traumatic ankle/foot injury:

Patient age is 55yrs or older
Unable to weight bear for 4 successive steps
Localised bony tenderness - posterior aspect of lateral or medial malleolus, over navicular, cuboid or 5th metatarsal.
Patient fails to show improvement after 7 days.

Question 2

Homan’s sign

Answer 2

DVT

Passive/abrupt/forced Ankle Dorsi flexion with knee extended and squeezing calf - may elicit pain

causes mechanical traction on the posterior tibial vein

Question 3

Achilles squeeze test

Answer 3

Achilles tendinopathy

Squeeze Achilles 2-6cm above insertion
Pain indicates tendinopathy

Question 4

Morton’s test

Answer 4

Morton’s neuroma

Firmly squeeze metatarsal heads with one hand applying direct pressure to dorsal/plantar interspace with the other hand.

Positive = pain

Question 5

Windlass test

Answer 5

Plantar Fascitis

Weight bearing/supine Dorsi Flex! Extend toes to stretch plantar fascia

Positive = pain in calcaneous.

Question 6

Calcaneal squeeze

Answer 6

Plantar fascitis

Positive = pain