Wk10-MSK Conditions

Question 1

Define hallux limitus

Answer 1

Progressive reduced dorsiflexion in the 1st MTPJ

Normal is 50-65deg

Question 2

Define hallux rigidus

Answer 2

Absence of dorsiflexion and plantar flexion and subsequent fusion of 1ST MTJP

Question 3

Causes of hallux limitus/rigidus

Answer 3

• first ray hypermobility
• Structural (Length of met, SiZe of met)
• Tight FHL
• excessive STJ pronation
• Trauma
• Inflammatory joint disease (RA, Gout)
• Systemic disease (diabetes- stiffening of soft tissue

Question 4

Treat of hallux limitus/rigidus

Answer 4

• rocker sole
  -padding and strapping (bow) to limit movement and rest it
  -analgesic
  -surgery

Question 5

Different causes of heel pain

Answer 5

1. Plantar fasciopathy- excessive strain on fascia which creates micro tears (diagnosed through US and a thickness of fascia 4mm+) Ddx:heel spur
2. Fat pad syndrome - loss of shock absorbing fat pad
3. Nerve entrapment
4. Calcaneal apophysitis

Question 6

Risk factors for heel pain

Answer 6

• middle age
• Obesity
• Reduced rom of ankle
• Pes planus
• Runner
• Poor footwear
• Prolonged standing

Question 7

Types of Tendinopathy

Answer 7

• tendinosis: tendon degeneration, no inflammation may be associated with rupture
• Paratendonitis: inflammation of the paratendon
• Tenosynvoitis: inflammation of synovial membrane surrounding tendon
• Tendinitis: inflammation of tendon

Question 8

Causes of Tendinopathy

Answer 8

• excessive loading
• Neurological
• Genetic
• Age/ sex (estrogen)/ body weight / chronic conditions
• Sport/ occupation

Question 9

Peace and love stands for

Answer 9

P-protect
E- elevate
A- avoid anti inflammatories
C- compression
E- education

L- load
O- optimism
V- vascularisation
E- exercise

Question 10

Define hallux valgus

Answer 10

progressive deformity of lateral deviation and valgus rotation of first met head. Symptoms can be treated, angle needs surgery

Question 11

What complications arise from hallux valgus

Answer 11

• joint subluxation = OA
• sesamoids laterally displace
• Medial bony eminence develops to enlarge met head
• First ray hypermobile and unstable (Associated with falls in older adults
• Trauma from footwear, pain
• Look

Question 12

Important things to consider with hallux valgus

Answer 12

-pain on palpation
-grade to track progression
-balance test/gait analysis
-assess footwear width and depth

Question 13

Treatment options for hallux valgus

Answer 13

-padding
-footwear modifications
-night splinting
-toe spacers
-surgery (long recovery)
1. Bunionectomy-removes medial eminence
2. Osteotomy- realigns met shaft
3. Arthroplasty- removal of proximal phalanx
4. Arthrodesis - joint fusion