Ortho Lower Extremity: Foot/ankle Specialized Physcial Exam Tests Flashcards Preview

Clinical Medication: HEENT > Ortho Lower Extremity: Foot/ankle Specialized Physcial Exam Tests > Flashcards

Flashcards in Ortho Lower Extremity: Foot/ankle Specialized Physcial Exam Tests Deck (12):
1

Anterior Drawer (ankle)

o Detects excessive anterior displacement of the talus on the tibia
o If anterior talofibular lateral ligament is torn by an inversion stress, the talus will sublux anteriorly and laterally out of the mortise
o Test performed with the patient’s foot in the neutral position (slightly plantar flexed and inverted)

2

External Rotation Stress Test (Ankle)

o Clinician stabilizes the leg proximal to the ankle joint while grasping the plantar aspect of the foot and rotating the foot externally relative to the tibia
o Positive test: pain is elicited in the region of the anterior tibiofibular ligament (anterior to the lateral malleolus and proximal to the ankle joint)
o Helps to identify a syndesmotic ankle sprain

3

Matles Test

Patient lies prone with knees flexed to 90 degrees

Observe whether the affected foot is dorsiflexed or neutral (both are abnormal)

Compare to uninjured side (foot should be plantar flexed)

4

Metatarsal compression test

Squeeze the metatarsals together with one hand and using the thumb and index finger of the other hand to compress the affected area to reproduce the pain/symptoms

Can indicate presence of metatarsalgia

5

Mulder’s sign

Clicking sensation when palpating the interspace and simultaneously squeezing the metatarsal joints

Can indicate presence of interdigital neuroma (Morton’s neuroma)

6

"Piano Key” test

Useful to assess for Lisfranc injury

Grasp toes and move them up and down to determine if pain results

Puts stress on midfoot and will cause pain if injury

7

Single limb heel rise

Stand on one foot and come up on “tip toes”

This places significant stress across midfoot

Results in pain if Lisfranc injury present

8

Squeeze test (ankle)

Compression of the fibula against the tibia at the mid-calf level

Positive test: pain is elicited in the region of the anterior tibiofibular ligament when a syndesmotic sprain has occurred

9

Stress examination of the midfoot

Grasp heel and twist the front of your foot to determine whether there is pain at the midfoot

Causes pain with Lisfranc injury but not with ankle injury

10

Talar Tilt Test

Detects excessive ankle inversion

If ligamentous tear extends posteriorly into the calcaneofibular portion of the lateral ligament, the lateral ankle is unstable and talar tilt occurs

With ankle in neutral position, gentle inversion force is applied to the affected ankle

Degree of inversion is observed and compared with the uninjured side

Limited usefulness in acute injury when pain, muscle spasm and swelling are present
More important in evaluating chronic ankle instability

11

Thompson test (calf squeeze test)

Patient either lie prone w/ feet hanging of the end of table or kneels on a chair

Clinician squeezed the gastrocnemius muscle belly while watching for plantar flexion

Absence of plantar flexion when squeezing the gastrocnemius muscle marks a positive test for rupture

More reliable than ability to plantar flex b/c this can also be done w/ accessory muscles

12

Tinel’s sign (tarsal tunnel)

Symptoms (paresthesias) are elicited by tapping over the path of the tibial nerve

Useful for assessing presence of tarsal tunnel syndrome