ChiroBoards3: Ddx Lower Leg Hit List
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| HX sudden or slow onset w/ abrupt dorsiflexion or plantar flexion of ankle PE = swelling tenderness and palpable fixation at the fibular head head may radiate into l tightened as in hammer toes, heavy heel strikeower leg | Proximal Tibial-Fibular Subluxation
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| HX = anterior muscles are placed under increased stress, prolonged running on hard surface, or poor foot wear. PE = pain in middle to lower third of tibia, just lateral to bone; extensor tendons may appear | Anterior shin splints
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| HX = posterior muscles placed under increased stress creating poor ankle stability and has hyperpronation PE= pain at middle or lower 3rd of tibia, posterior and medial to bone, heavy pronation during gait | Posterior shin splints
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| HX = Insideous onset of tibial pain, overuse from prolonged running, walking PE = High arch, leg length discrepancy, forefoot varus, tuning fork may be positive | Tibial Stress Fracture
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| HX = aching or cramping of leg after or during activity such as exercise/running. Can ocur with acute trauma or fx. PE = depends on compartment involved. May be normal except during inciting activity, swelling, heat, muscle herniations may be present. | Compartment Syndrome
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| HX = pain in achilles tendon following running or jumping activity PE = Tender to palpation with exacerbating movement; may have deformity, site swelling, usually 2 cm proximal to insertion on calcaneus. Can lead to "Haglunds" deformity. | Achilles Tendonitis
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| HX = Calf pain that is worse with walking, hx of surgery, minor trauma, long periods of inactivity such as flying long distance. PE = swelling, heat, pain, positive Homan's sign | Thrombophlebitis
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| Hx of trauma of lower leg PE = reduced range of motion, possibly swelling, warmth, redness, and pain | Lower Leg Sprain/Strain
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| Most often lower back symptoms with diagnosable nerve root compromise referring symptoms to the lower leg. PE = most likely Dejerene's will reproduce symptoms | L4-S1 radiculopathy
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| Pt. with hx of cervical cord compression usually of a long standing nature. Symptoms will be global involving spine/back and upper extremity. Dejerene's reproduces symptoms | Cervical myelopathy
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| Most likely hx of stenotic symptoms including claudication relief by forward flexion of the spine. Symptoms not isolated to the lower leg, but also in the thighs, hips, and back likely | Canal Stenosis
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| Usually young male localized lower leg pain, relieved by asprin, hurts at night, x-ray definitive, treatment is surgical excision | Osteoid Osteoma (and other bone tumors)
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| M/c lower leg peripheral nerve entraptments (3) | Sural nerve, Deep or Superficial Peroneal Nerve
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Created by:
bglasman
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