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Foot Pathologies

Foot and Toe Pathologies

QuestionAnswer
Hallux Valgus Progressive degeneration and subluxation of the first MTP joint.
Hallux Valgus Identifying Information 1/2 Valgus angulation of the first toe, the first and second toe may overlap, bunion formation over the medial border of the first MTP joint. The medial joint and sesamoids may be tender to the touch, thickening of the synovial capsule may be noted.
Hallux Valgus Identifying Information 2/2 AROM: Pain may be produced during flexion and extension. MMT: Extensor hallucis longus is weak secondary to pain. PROM: pain may be produced during flexion and extension. Special Tests: Not applicable
Hallux Valgus Differential Diagnosis Osteoarthritis, septic arthritis, sesamoiditis, sprain, hallux rigidus, gout.
Hallux Rigidus Literally meaning "stiff great toe" progressive degeneration of the first MTP joint's articular surfaces.
Hallux Rigidus Identifying Information 1/2 Often unremarkable inspection. Swelling may be noted in the forefoot. Point tenderness b/t the affected MT heads. Pain is increased when squeeing the transverse arch, compressing the MT heads. A palpable nodule may be noted. AROM: unremarkable.
Hallux Rigidus Identifying Information 2/2 MMT: Possible increased pain with toe flexion. PROM: Unremarkable findings. Special Tests: Mulder sign.
Hallux Rigidus Differential Diagnosis Stress fracture, arthritis, metatarsalgia, proximal nerve compression.
Lisfranc Injury Injury to the lisfranc joint including: sprains, dislocations, fractures, or fracture dislocations through the tarsometatarsal joints.
Lisfranc Injury Identifying Information 1/2 Swelling over the dorsum of the foot, displacement of the MT'S may be noted. FRacture-dislocations are marked by an apparent shortening and widening of the involved foot. Point tenderness over the TMT joints and fractured MTs.
Lisfranc Injury Identifying Information 2/2 AROM: decreased pronationa and supination. MMT: decreased strenth secondary to pain is found during pronation, supination, dorsiflexion, and plantarflexion. PROM:Pain at end range of all motions. Special Tests: Not applicable
Lisfranc Injury Differential Diagnosis Tarsal fracture, MT fracture
Metatarsal Fracture Fracture of one of the metatarsals
Metatarsal Fracture Identifying Information 1/3 Gross deformity and or swelling may be visible along the shaft of the bone. Stress fractues may reveal no significan signs, but localized swelling around the painful area may be present.
Metatarsal Fracture Identifying Information 2/3 Tendrness and crepitus may be present over the site of acute fractures of maturing stress fractures. A false joint may be present with acutely fractured metatarsals. AROM: results in pain. MMT: Contraindicated if fx is suspected. May reproduce pain.
Metatarsal Fracture Identifying Information 3/3 PROM: Typically results in pain Special Tests: Long bone compression test
Metatarsal Fracture Differential Diagnosis Stress fractures, interdigital neuromas, tarsal tunnel syndrome, acute fracture, sprain, dislocation.
Tarsal Tunnel Syndrome Caused by entrapment of the posterior tibial nerve or one of its medial or lateral branches as it passes through the tarsal tunnel.
Tarsal Tunnel Syndrome Identifying Information 1/2 Inspection of the medial longitudinal arch reveals pes planus. Palpation over the tibial nerve and its branches results in tenderness, especially in the area of the tarsal tunnel behind the lateral malleolus and beneath the flexor retinaculum.
Tarsal Tunnel Syndrome Identifying Information 2/2 AROM: Motor function fo the intrinsic and extrinsic muscles is often normal. MMT: Normal. PROM: Forced dorsiflexion and eversion may increase symptoms. Special Tests: Dorsiflexion-eversion test for tarsal tunnel syndrom, tinel sign
Tarsal Tunnel Syndrome Differential Diagnosis Plantar fasciitis, posterior tibialis tendinopathy, talcalcaneal coalition, calcaneal stress fracture.
Plantar Fasciitis Aggravation of the plantar fascia or the junction between the fascia and the first layer of intrinsic muscles.
Plantar Fasciitis Identifying Information 1/2 Swelling may be noted on the plantar aspect near the calcaneus. Pes planus or pes cavus may be noted. Pain is at or near the origin of the plantar fascia. Tissue thickening may be palpable in chronic cases. AROM: Decreased ankle DF.
Plantar Fasciitis Identifying Information 2/2 MMT: Increased pain with test of flexor digitorum brevis. PROM: Decreased ankle DF w/ pain at end range. Pain during passive extension of the MTP joints. Special Tests: Navicular Drop test, Test for supple pes planus.
Plantar Fasciitis Differential Diagnosis Heel spur, calcaneal fracture/stress fracture, tarsal tunnel syndrome.
Created by: soccerizmygame