Foot Pathologies Flashcards
Bunions / Hallux Vagus
Symptoms: reddened skin over base of big toe, pain over joint where big toe joins the foot, MTP joint aggravated by pressure from shoes.
Gait: overpronation due to first rat instability, degraded toe-off
Clavus Mollis
AKA Soft Corns, heloma molle, interdigital corns
Caused by pressure from bony prominence on the next toe, often brought on by shoes that squeeze the toes together.
Gait: pain can impair gait substantially
Clavus Durus
AKA Hard corns, heloma durum
Thickened layers of skin caused by repeated pressure/ friction
Well circumscribed, have conical keratin core
Gait: abnormal gait which can then cause corns.
Equinus
Spastic equinus may develop in patients with neuromuscular disease.
If muscles in the back of the leg overpower the muscles in the front, then equinus may develop.
Non-spastic equinus can be hereditary with a short Achilles tendon.
Gait: walk more on toes, bouncy gait, foot is unable to fully dorsiflex
Metatarsalgia
General term for painful foot in metatarsal region.
Affects all bones/joints in the ball of the foot.
Common for patients with RA.
Gait: Tries to avoid pain associated with ambulation, often quick, short & soft steps
Morton’s Toe
Forefoot disorder, 2nd met is longer than 1st met/hallux.
Excessive pressure on 2nd met head / pain
Can lead to callus formation under second met head
Gait: protective to avoid pressure/pain
Plantar Warts
Hyperkeratotic lesions at plantar surface.
Tend to develop in areas of pressure (heel/ball)
Often endophytic
Should be treated to reduce transmission and decrease duration.
Caused by indirect exposure to HPV to the epidermis (ex. public showers)
Common (7-10% of population) & at any age
Usually over bony prominences
Gait: Tries to avoid pain associated with ambulation, often quick, short & soft steps - like having a stone in your shoe
Plantar Fasciitis
Gait: Usually first step in the morning is painful, then tries to avoid pain associated with ambulation, often quick, short & soft steps.
Ankle Arthorodesis
Removal of cartilage/diseased bone from a joint to produce a fusion of at least 2 bones to create one bone.
Joint surfaces are pressed together with some sort of fixation.
Gait: Decreased sagittal ROM, decreased plantarflexion at toe off, decreased stride length, hyperextension of knee after foot flat is achieved w/o compensatory ankle dorsiflexion resulting in excess strain on the knee. Difficult toe clearance in swing phase, toe drag, compensatory hip/knee flexion or circumduction of the lower limb.
Claw Toe
Congenital or acquired
May result from spinal cord or peripheral nerve problems.
Not dangerous themselves but could be symptomatic of a more serious condition / disease of nervous system.
Dorsiflexed PIP, flexed MTP, flexed DIP
Gait: gait and balance issues
Hammer Toe
End of the toe is bent downward.
Usually affects 2nd toe
Occurs from pressure of bunion
High arch may develop
Contracture of MTP, dorsiflexed PIP, Plantarflexion of MTP
Gait: gait and balance issues
Mallet Toe
End of the toe cannot straighten.
Tip of the toe is durned down against shoe causing pain/discomfort.
DIP plantarflexed
Gait: gait and balance issues
Diabetic Ulcers
Microvascular disease / sm vessel disease.
Diabetics are prone to ulcers because of neurological and vascular complications.
Early symptoms: redness, blistering, irritation
Later stages: open wound that drains, can become infected
Gait: Shorter stride, wider stance
Orthoses: extra depth shoes, blucher openings to allow easy entry into shoes, shock absorbing soles, low heals to decrease pressure, rocker sole.
Hallux Rigidus/Limitus
Diminished motion in the first MTP joint
Result of traumatic arthritis of first MTP joint, motion ceases to occur. 1st ray - fixed or rigid
Can result from trauma or bunion surgery
Symptoms: gradually increasing toe stiffness/pain, smooth skin under 1st met heads,
Gait: spinning of the toe in the toe-off phase
Limb Length Discrepancy
Symptoms: neck pain, shin splints, patella tendonitis, sciatica, arthritis of hip/knee, change in structure of lumbar vertebrae
Gait: lateral lurch to the affected side, head bobs during stance phase on the short leg.
