Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Yr3 MSK -ak > Foot problems > Flashcards

Foot problems Flashcards

1
Q

What is Achilles tendonitis?

A

Degenerative/overuse condition with little inflammation. (misnomer)
Tendinosis histopathological.
Tendinopathy term to describe symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the subtypes of Achilles tendonitis and their associations

A

Paratendinopathy - common in athletics, age 30-40, M 2:1 F.

Tendinopathy – commonest in non-athletics, aged > 40, obesity, steroids, diabetes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the symptoms of Achilles tendonitis?

A 
Pain during exercise.
Pain following exercise.
Recurrent episodes.
Difficulty fitting shoes (insertional).
Rupture – don’t miss.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the non-operative management for Achilles tendonitis?

A

Non-operative: activity modification, weight loss, shoe wear modification (slight heel raise), Physiotherapy (eccentric stretching), extra-corporeal shockwave treatment, immobilisation (in below knee cast).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are operative management options for Achilles tendonitis?

A

Gastrocnemius recession. Release and debridement of tendon.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe plantar fasciosis?

A

Chronic degenerative change, fibroblast hypertrophy, absence inflammatory cells, disorganised and dysfunctional blood vessels and collagen, avascularity. Can’t make extra cellular matrix required for repair and remodelling.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the aetiology of plantar fasciosis?

A

Not known. In athletes associated with high intensity or rapid increase in training. Running with poorly padded shoes or hard surfaces. Obesity. Occupations involving prolonged standing. Foot/lower limb rotational deformities. Tight gastro-soleus complex.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the symptoms of plantar fasciosis?

A

Pain first thing in morning
Pain on weight bearing after rest - Post-static dyskinesia (impairment of movement)
Pain located at origin of plantar fascia
Frequently long lasting – 2 years or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the management for plantar fasciosis?

A 
Rest, change training. 
Stretching – Achilles +/- direct stretching 
Ice 
NSAIDs
Orthoses – heel pads 
Physiotherapy 
Weight loss
Injection – CCS (good in short term but may worsen condition in long term) 
Night splinting.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the aetiology of ankle OA + the mean age of presentation?

A

Mean age of presentation is 46 years. Commonly post-traumatic. Idiopathic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the symptoms of ankle OA?

A

Pain, stiffness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What non-operative treatments are there for ankle OA?

A

Weight loss, activity modification, analgesia, physiotherapy, steroid injections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What operative treatment can be used for ankle OA?

A
  • If symptoms are exclusively anterior – arthroscopic anterior debridement
  • Arthrodesis – open or arthroscopic: gold standard, good long-term outcome.
  • Joint replacement – maintain ROM, questionable long-term outcome esp. in high demand patients, not easy to revise even to fusion.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is tibialis posterior dysfunction?

A

Acquired adult flat foot planovalgus. Relatively common, under-recognised. Comes in 4 stages.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the symptoms of tibialis posterior dysfunction and describe the diagnosis?

A

Symptoms- medial or lateral pain. Largely clinical diagnosis – double & single heel raise (tip toes). Too many toes sign when looking from behind and stood up.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How would you treat tibialis posterior dysfunction?

A 
Orthotics – medial arch support.
Reconstruction of tendon (tendon transfer) 
Triple fusion (subtalar, talonavicular and calcaneocuboid)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is hallux valgus also known as?

A

“bunions”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the aetiology of hallux valgus?

A

Genetic, footwear, significant female preponderance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the pathogenesis of hallux valgus

A

Lateral angulation of great toe, tendons realigned to lateral of central of rotation, vicious cycle of increasing pull creating increasing deformity, sesamoid bone subluxation (partial dislocation) – less weight going through big toe, as deformity progresses, abnormalities of lesser toes occur.

20
Q

What are the treatments of hallux valgus (non-op + op)?

A

Non-operative: shoe wear modification (wide +/- high toe box); Orthotics to offload pressure/correct deformity; Activity modification; Analgesia.
Operative – release lateral soft tissues; Osteotomy 1st metatarsal +/- proximal phalanx; generally good outcome but recurrence inevitable.

21
Q

What is hallux rigidus?

A

Latin – stiff big toe. OA of 1st MTP joint.

22
Q

What is the aetiology of hallux rigidus?

A

Not known. Possibly genetic – typical shape of metatarsal head is slightly pointed rather than rounded. Possibly multiple microtrauma.

23
Q

What are the symptoms of hallux rigidus?

A

Many asymptomatic. Pain – often at extreme dorsiflexion. Limitation of ROM.

24
Q

How do you treat hallux rigidus? (op + non-op)

A

Non-operative – activity modification, shoe wear with rigid sole, analgesia.
Operative – Cheilectomy (remove dorsal impingement); Arthrodesis; Arthroplasty.

25
Q

What is rheumatoid forefoot?

A

RA of the forefoot

26
Q

What is the management of rheumatoid forefoot?

A

Non-operative – shoe wear/orthotics/activity etc.
Operative – current gold standard:
- 1st MTPJ arthrodesis
- 2-5th toe excision arthroplasty

27
Q

Describe metatarsalgia

A

Symptom, not diagnosis; careful examination should localise the cause. Synovitis, bursitis, arthritis, neuralgia, (Morton’s) neuromata, Freiberg’s disease. If no obvious cause, consider tight gastrocnemius. Sometime difficult problem to treat.

28
Q

Describe the aetiology of hammer and claw toe (lesser toe deformities)

A

Imbalance between flexors/extensors. Shoe wear. Neurological. RA. Idiopathic.

29
Q

What are the symptoms of hammer/claw toe?

A

Deformity. Pain from dorsum. Pain from plantar side (metatarsalgia).

30
Q

What are the non-operative treatments for hammer + claw toe (lesser toe deformities)?

A

Activity modification. Shoe wear – flat shoes with high toe box to accommodate deformity. Orthotic insoles – metatarsal bar/dome support.

31
Q

What are the operative treatments for hammer + claw toes (lesser toe deformities)?

A

Flexor to extensor transfer
Fusion of IPJ
Release of MTPJ
Shortening osteotomy of metatarsal

32
Q

What is the origin of dorsal foot ganglia?

A

Arises from joint or tendon sheath.

33
Q

What may be aetiological factors for dorsal foot ganglion?

A

Idiopathic. Underlying arthritis. Underlying tendon pathology.

34
Q

What are the symptoms of dorsal foot ganglia?

A

Pain from pressure from shoe wear. Pain from underlying problem.

35
Q

How may you treat dorsal foot ganglia?

A

Non-operative – aspiration. Operative – excision.

36
Q

What may midfoot arthritis be a result of?

A

Post-traumatic arthritis. OA. RA.

37
Q

How do you treat midfoot arthritis?

A

Non-op: activity/shoe wear/orthotics etc.
Injections – x-ray guided
Operative – fusion

38
Q

Describe plantar fibromatosis

A

AKA Ledderhose disease, characterised by growth of hard and round or flattened nodules on soles of feet. Progressive. Usually asymptomatic unless very large or on WB area.

39
Q

How would you treat plantar fibromatosis?

A

Non-operative – avoid pressure, shoe wear/orthotics
Operative – excision (up to 80% risk of recurrence)
Radiotherapy (similar recurrence as operative)
Combination radiotherapy/surgery (low risk recurrence/high risk complications)

40
Q

What is the aetiology of diabetic foot ulcer?

A

Diabetic neuropathy – patient unaware to trauma to foot
Diabetic autonomic neuropathy
Lack of sweating/normal sebum production
Dry cracked skin
Skin more sensitive to minor trauma
Poor vascular supply
Lack of patient education

41
Q

Describe the management of diabetic foot ulcers

A

Prevention.
Modify main detriments to healing – Diabetic control, smoking, vascular supply, external pressure (splints/shoes/WB), internal pressure (deformity), infection, nutrition.
Surgical treatment – improve vascular supply; debride ulcers + get samples for microbiology; correct any deformity; amputation.

42
Q

Describe the prognosis of diabetic foot ulcers

A

15% of diabetics –> foot ulcers.
85% of amputations preceded by foot ulcers; 25% of diabetic foot ulcer get amputated
5-year mortality 50%

43
Q

Describe the aetiology of Chargot’s neuroarthropathy

A

Any cause of neuropathy. Diabetes most common cause. Historically originally described and most common with syphilis.

44
Q

Describe the pathology of Chargot’s neuroarthropathy?

A

Characterised by rapid bone destruction occurring in 3 stages: fragmentation, coalescence, remodelling.

45
Q

Describe the management of Chargot’s neuroarthropathy?

A

Prevention, immobilisation/non weight bearing until acute fragmentation resolved. Correct deformity – deformity leads to ulceration leads to infection leads to amputation.

Yr3 MSK -ak (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions