Term
| What is the "terrible triad"? |
|
Definition
| ACL, MCL, and MMT (medial meniscus tear) |
|
|
Term
| Most sensitive test for ACL insufficiency is? |
|
Definition
|
|
Term
| How do you perform the Lachman test? |
|
Definition
| knee is flexed to 25-30° and the tibia is gently pulled forward while the femur is stabilized; inc. motion of the tibia indicates complete ACL tear |
|
|
Term
| Why isn't the anterior drawer test all that great for Dx-ing an acute ACL tear? |
|
Definition
| it's negative in 50% of acute ACL tears |
|
|
Term
| What is the Pivot shift test and how do you perform it? |
|
Definition
| Flexion and valgus force on the extended knee with the foot in internal rotation results in reduction of the knee with a "clunk" at 20 to 30 degrees of flexion in the patient with an ACL injury |
|
|
Term
|
Definition
| fracture of the lateral capsular margin of the tibia |
|
|
Term
| What is the initial Tx of an acute ACL injury? |
|
Definition
| RICE, NSAIDS, Narcotics, Crutches |
|
|
Term
| What's more important to achieve with ACL rehab: flexion or extension? |
|
Definition
|
|
Term
| When should physical therapy/rehab begin after an ACL tear? What about surgery? |
|
Definition
| as soon as swelling permits, start work on regaining full flexion and extension; no surgery until at least 8 weeks after injury |
|
|
Term
| Fancy term for scarring of the knee joint |
|
Definition
|
|
Term
| Strongest ligament in the knee |
|
Definition
|
|
Term
| Most sensitive test for PCL tear? |
|
Definition
|
|
Term
| What is another test for a PCL tear (that isn't the most sensitive)? |
|
Definition
| quadriceps active drawer test |
|
|
Term
| What is the posterior sag sign? |
|
Definition
| With the patient lying supine, the hip and knee are flexed 90 degrees - Posterior subluxation of the tibia in relation to the femur is a positive sign of PCL tear |
|
|
Term
| PCL rehab focuses on strengthening which muscles once swelling subsides and ROM is back? |
|
Definition
| quads - exercises from 30 degrees of flexion to 0 degrees |
|
|
Term
| Which ligaments are "inside" the knee joint, and which are "outside"? |
|
Definition
| ACL, PCL inside; MCL, LCL outside |
|
|
Term
| A twisting injury is usually responsible for which knee ligament tears? |
|
Definition
|
|
Term
| An MCL injury usually occurs due to ... ? |
|
Definition
| valgus force without rotation (football clipping injury) |
|
|
Term
| MCL or LCL tear: which is more common? |
|
Definition
|
|
Term
| An LCL injury usually occurs due to ... ? |
|
Definition
| pure varus force to the knee; hitting the knee from the inside and pushing it away from the body |
|
|
Term
| Which knee ligament(s) tear may occur and PT is able to still able to finish out the game he was playing? |
|
Definition
|
|
Term
| During an exam involving knee injury, what is an important first step (vague I know)? |
|
Definition
| examine uninjured knee first to determine "normal" |
|
|
Term
| MCL is best palpated how? |
|
Definition
|
|
Term
| LCL is best palpated how? |
|
Definition
|
|
Term
| Which size joint space opening is a grade I MCL/LCL tear? |
|
Definition
|
|
Term
| Which size joint space opening is a grade 2 MCL/LCL tear? |
|
Definition
|
|
Term
| Which size joint space opening is a grade 3 MCL/LCL tear? |
|
Definition
|
|
Term
| What is the standard Tx of a MCL tear? |
|
Definition
| usually non-operative, even with rupture; RICE, NSAIDS, crutches. hinged brace for 4-6 weeks for grade III |
|
|
Term
| What is the standard Tx of a LCL tear? |
|
Definition
| LCL grade III needs surgery, I & II don't. otherwise- RICE, NSAIDS, crutches |
|
|
Term
|
Definition
| point tenderness over medial or lateral joint line |
|
|
Term
| A bucket handle tear is ? |
|
Definition
| large unstable fragments of meniscal tissue can become incarcerated in the knee joint - leads to "locked" knee and requires URGENT ortho eval |
|
|
Term
| PT has pain with twisting or squatting - Dx? |
|
Definition
|
|
Term
| What tests are performed to rule in a meniscus tear? |
|
Definition
|
|
Term
| MC location of Osteochondritis dissecans? |
|
Definition
| lateral side of medial femoral condyle (palpate with knee at 90 degrees) |
|
|
Term
| Tx of Children with osteochondritis dissecans is? |
|
Definition
| lesion <1cm: non-op Tx; 1-2 cm: based on S/S; >2 cm: Surgery |
|
|
Term
| MC compartment of the knee to have OA? This results in what visible issue? |
|
Definition
| medial compartment; bowleg/genu varum deformity |
|
|
Term
| What is the best x-ray view to order for knee OA? |
|
Definition
| weight-bearing of both knees in full extension will show narrowing of the joint space |
|
|
Term
| Which patellar "pole" is MC to not unite, thereby causing a bipartite patella? |
|
Definition
|
|
Term
| What are the 5 bursal sacs in the knee? |
|
Definition
| pre-patellar, supra-patellar, infra-patellar, pes answerine, iliotibial tract |
|
|
Term
| What's another name for Housemaid's knee? Where'd that name come from? |
|
Definition
| prepatellar bursa; chronic kneeling while cleaning |
|
|
Term
| The suprapatellar bursa lies deep to what muscle? |
|
Definition
|
|
Term
| What muscles insert at the pes anserinus? Where is this insertion? |
|
Definition
| sartorius, gracilis, and semitendinosus; medial tibia just below tibial plateau Forces on the articular surface of the patella in |
|
|
Term
| a typical 200-lb man can vary from ________ to ___________ lb per sq. inch in activities like running and walking. |
|
Definition
|
|
Term
| theatre sign indicates what problem? |
|
Definition
|
|
Term
| MC is diffuse aching anterior knee pain that is worse after prolonged sitting |
|
Definition
|
|
Term
| A PT walks and the patellae point towards each other. What is this gait called? |
|
Definition
| increased femoral anteversion |
|
|
Term
|
Definition
| the angle constructed by a line drawn from the anterosuperior iliac spine (ASIS) to the center of the patella, and from there to the center of the tibial tubercle |
|
|
Term
| What should the Q angle be in women? |
|
Definition
| < 22 degrees with knee in extension AND < 9 degrees with knee in 90 degrees of flexion |
|
|
Term
| What should the Q angle be in men? |
|
Definition
| < 18 degrees with knee in extension AND < 8 degrees with knee in 90 degrees of flexion |
|
|
Term
| What test is performed to evaluate the possibility of patellar instability? |
|
Definition
| patellar apprehension sign |
|
|
Term
| "judicious (prudent) use" of corticosteroid use should be performed with what knee problem? |
|
Definition
|
|
Term
| What is the Fulkerson procedure? |
|
Definition
|
|
Term
| Jumper's knee is another term for? |
|
Definition
|
|
Term
| Hallmark of patellar/quad tendinitis? |
|
Definition
| anterior knee pain - probably point tenderness |
|
|
Term
| First Tx of patellar/quad tendinitis is:? |
|
Definition
| rest from aggravating exercises for 3 days - 3 weeks; no corticosteroids! |
|
|
Term
| 2nd phase of patellar/quad tendinitis Tx is? |
|
Definition
| regain pain-free ROM, strength through exercises |
|
|
Term
| A compression strap may be helpful with what knee condition? |
|
Definition
|
|
Term
| 3rd phase of patellar/quad tendinitis is? |
|
Definition
| gradual resumption of activities that caused the symptoms |
|
|
Term
| Key to Dx of patellar/quad tendon rupture is? |
|
Definition
| PT's inability to extend knee against gravity, perform straight-leg raise, or short-arc quad test |
|
|
Term
| What 2 tests MUST a PT perform with all acute knee injuries? |
|
Definition
| straight leg-raise & short-arc quad tests. (Must be able to fully extend knee?) |
|
|
Term
|
Definition
| Patellar tendon rupture; patella is in a higher than usual location (lateral x-ray view) |
|
|
Term
|
Definition
|
|
Term
| Tx of choice for complete rupture of quad or patellar tendons? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What are the 5 knee joint plica? |
|
Definition
| suprapatellar, medial, infrapatellar (major folds); 2 unnamed minor ones |
|
|
Term
| "bowstrings" over the femoral condyle |
|
Definition
|
|
Term
| Which plica most often becomes pathologic? |
|
Definition
|
|
Term
| With a pathologic plica, a pop may occur at about _____ degrees of flexion. |
|
Definition
|
|
Term
| Standard Tx of plica syndrome? |
|
Definition
| NSAIDS, modification of activities. Injection of local anesthetic and corticosteroid into the plica is both diagnostic and therapeutic |
|
|
Term
|
Definition
| Compartment syndrome, contusions, medial gastroc tear, ruptured popliteal cyst |
|
|
Term
| 4 leg compartments are? Which one is MC to cause compartment syndrome? |
|
Definition
| anterior (MC), lateral, posterior, deep posterior |
|
|
Term
| Structures in Anterior leg compartment? What nerve(s) innervates them? |
|
Definition
| Tibialis anterior, Extensor hallucis longus, Extensor digitorum longus, Peroneus tertius; Deep peroneal nerve |
|
|
Term
| Structures in Lateral leg compartment? What nerve(s) innervates them? |
|
Definition
| Peroneus longus, Peroneus brevis; superficial peroneal nerve |
|
|
Term
| Structures in Posterior leg compartment? What nerve(s) innervates them? |
|
Definition
| Gastrocnemius, soleus, plantaris; tibial nerve |
|
|
Term
| Structures in Deep Posterior leg compartment? What nerve(s) innervates them? |
|
Definition
| Popliteus, Flexor hallucis longus, Flexor digitorum longus, Tibialis Posterior; tibial nerve |
|
|
Term
| Hallmark symptom of acute compartment syndrome is? |
|
Definition
| leg pain out of proportion to expected |
|
|
Term
| Late finding of compartment syndrome? |
|
Definition
| paresthesias or numbness of the foot; dec. sensation may occur at onset - but paralysis and loss of pulses are late findings |
|
|
Term
| Pressure difference in compartment syndrome is what range? |
|
Definition
| DP minus intracompartmental pressure is less <= 30 mm Hg OR absolute pressure of 40mm Hg or higher in the compartment |
|
|
Term
|
Definition
| injury to leg sustained from a direct blow |
|
|
Term
| The patient holds the ankle in plantar flexion to avoid placing tension on the injured muscle. What injury is this? |
|
Definition
| medial gastrocnemius tear |
|
|
Term
| A Baker's cyst develops where specifically? |
|
Definition
| in the popliteal bursa located at the posteromedial aspect of the knee joint |
|
|
Term
| Popliteal cysts are associated with what 2 conditions? |
|
Definition
| degenerative meniscal tears and RA |
|
|
Term
| MC location of popliteal cysts in relation to local muscles is? |
|
Definition
| between semimembranosus and medial head of gastrocnemius |
|
|
Term
| A Baker's cyst rupture may be confused with what other condition? |
|
Definition
|
|
Term
| Def. of chronic leg pain? |
|
Definition
| pain for more than 2-3 weeks |
|
|
Term
| Exertional compartment syndrome pressures usually subside after how long? |
|
Definition
| within 30 mins after exercise weakness of the foot dorsiflexors and paresthesias in the dorsum |
|
|
Term
| of the first web space - what is this? |
|
Definition
| probably exertional compartment syndrome |
|
|
Term
| What must be ruled out before you can Dx a shin splint? |
|
Definition
| stress Fx and exertional compartment syndrome |
|
|
Term
|
Definition
| discomfort in legs associated with activity that is secondary to a neurogenic or vascular etiology |
|
|
Term
| Neurogenic Claudication is associated with .... ? |
|
Definition
|
|
Term
| Ischemia to the cauda equina is the underlying pathology of this problem. |
|
Definition
|
|
Term
| Vascular Claudication is due to ... ? |
|
Definition
| peripheral vascular disease and compromised blood flow with walking |
|
|
Term
| vague pain that begins in the buttocks and spreads to the legs while walking |
|
Definition
|
|
Term
| Which claudication progresses from proximal to distal? |
|
Definition
|
|
Term
| Which claudication progresses from distal to proximal? |
|
Definition
|
|
Term
| Which type of claudication does not resolve with cessation of walking? |
|
Definition
| neurogenic; however, vascular stops with rest |
|
|
Term
| Tx of vascular claudication? |
|
Definition
|
|
Term
| Tx of neurogenic claudication? |
|
Definition
| NSAIDS, steroid shots, exercises, maybe surgery |
|
|
Term
| What is the Thompson test and what is it used for? |
|
Definition
| Place patient prone, squeeze calf, and check for passive plantar flexion. If no flexion, test is positive for Achilles tendon rupture. Best done w/i 48 hours of rupture |
|
|
Term
| What type of cast for Achilles tendon rupture? |
|
Definition
| bulky Jones posterior ankle split |
|
|
Term
| The most common mechanism of injury for an ankle sprain is (which direction) and stress on which ligaments? |
|
Definition
| ankle inversion; stresses lateral ligamentous stabilizers (PTFL, ATFL, CFL) |
|
|
Term
| MC ankle ligament injured and is ALWAYS injured first. |
|
Definition
|
|
Term
| Squeeze test is used for? |
|
Definition
| Tibiofibular syndesmosis (ankle sprain?) |
|
|
Term
| External Rotation Test is used for? |
|
Definition
| Tibiofibular syndesmosis (ankle sprain?) |
|
|
Term
| What test will tell you if the ATFL has been disrupted in an ankle sprain? |
|
Definition
|
|
Term
| What test will tell you if the CFL has been disrupted in an ankle sprain? |
|
Definition
| Talar tilt test (remember, if positive, ATFL will be injured as well) |
|
|
Term
| What is a Maisonneuve's Fx? |
|
Definition
| proximal fibula fractures arise from rotational injuries where force is transmitted proximally through the syndesmotic ligaments;Fx of proximal fibula, tear of medial deltoid ligament, disruption of the tibiofibular syndesmotic ligaments |
|
|
Term
| What are the Ottowa rules and what do they pertain to? |
|
Definition
| Tenderness to palpation at tip of lateral malleolus, medial malleolus, and inability to bear weight at the time of injury or time of physical exam; indications for x-raying an acute ankle injury (if any rules are true) |
|
|
Term
| In midfoot arthritis, joint space narrowing is especially evident at what joint? |
|
Definition
|
|
Term
|
Definition
| OA of MTP joint of great toe |
|
|
Term
| What is the initial Tx for ankle arthritis? |
|
Definition
| NSAIDs, orthotic inserts, stiff-soled shoe with a rocker bottom for hallux rigidus. You can get a corticosteroid shot if you think it would be helpful. |
|
|
Term
| Predictable pain relief of ankle arthritis can be obtained with? |
|
Definition
| a subtalar arthrodesis. Ankle motion is still retained after fusion. |
|
|
Term
|
Definition
| deformity of 5th MP join (basically a bunion, but of the small toe) |
|
|
Term
| Medial deviation of the small toe is probably? |
|
Definition
| bunionette - also could be a Fx, or other things... |
|
|
Term
| What is the usual cause of a bunionette? |
|
Definition
| freq. wearing of tight, narrow, pointed-toe shoes |
|
|
Term
| What is the initial Tx for a Bunionette? |
|
Definition
| wear proper shoes, get a modified metatarsal pad, use a medial longitudinal arch support |
|
|
Term
| What is the Tx of a bunionette when inital Tx failed? |
|
Definition
| osteotomy and realignment |
|
|
Term
|
Definition
| hyperkeratotic lesion of the skin that forms in response to excessive pressure over a bony prominence |
|
|
Term
|
Definition
|
|
Term
|
Definition
| hard corn that occurs over bony prominences |
|
|
Term
|
Definition
| soft corn that occurs between toes |
|
|
Term
| Warts are tender with what palpation? |
|
Definition
| pinched from side to side |
|
|
Term
| Corns/Calluses are tender with what palpation? |
|
Definition
|
|
Term
| What is the inital Tx of a corn? |
|
Definition
| paring and pressure relief |
|
|
Term
| What is Charcot Arthropathy? |
|
Definition
| a progressive musculoskeletal condition characterized by joint dislocation, fractures and deformities (related to Diabetic foot) |
|
|
Term
| What is the primary etiology of "the diabetic foot"? |
|
Definition
| peripheral nerve impairment that results in loss of protective sensation, autonomic dysfunction, and/or motor impairment |
|
|
Term
| Charcot arthropathy may be misdiagnosed as what 3 things? What is the best test to differentiate between all 4 things? |
|
Definition
| Cellulitis, osteomyelitis, gout; Elevate the foot for 1 min - if redness goes away it's CA. |
|
|
Term
| What is the best exam test for a Charcot foot? |
|
Definition
| A Charcot foot elevated above the heart for 1 minute will lose its redness, whereas a foot affected by cellulitis, soft-tissue abscess, and/or osteomyelitis will not |
|
|
Term
| What special radiology test can you do to differentiate between Charcot arthropathy and osteomyelitis? |
|
Definition
| Combined technetium-iridium bone scan |
|
|
Term
| An ankle sprain due to eversion would injure what ligaments? |
|
Definition
|
|
Term
| With ankle sprains, what should you look for to determine the extent of swelling? |
|
Definition
| wrinkles - if there are no wrinkles, swelling needs to come down before surgery in order to close the wound |
|
|
Term
| What measurement important to know regarding Maisonneuve's Fx? |
|
Definition
| >4mm is bad - not positive on the details |
|
|
Term
| What is the term for a toe plus metatarsal? |
|
Definition
|
|
Term
| What Tx is often needed to eradicate osteomyelitis of the toes or metatarsal heads? |
|
Definition
|
|
Term
| How long can Tx of Charcot arthropathy take? |
|
Definition
| leg might be in a brace for up to 12 months - may even need a permanent brace |
|
|
Term
| What is Danis-Weber AO classification Type A? |
|
Definition
| fibular Fx below syndesmosis (ankle Fx) |
|
|
Term
| What is Danis-Weber AO classification Type B? |
|
Definition
| fibular Fx at level of syndesmosis |
|
|
Term
| What is Danis-Weber AO classification Type C? |
|
Definition
| fibular Fx above syndesmosis |
|
|
Term
| Tx of Danis-Weber Type A? |
|
Definition
| closed reduction with casting |
|
|
Term
| Tx of Danis-Weber Type B? |
|
Definition
| closed reduction and casting unless examination reveals a syndesmotic disruption |
|
|
Term
| Tx of Danis-Weber Type C? |
|
Definition
| Treatment is open reduction with internal fixation (ORIF) |
|
|
Term
| A fracture of the distal fibula (lateral malleolus) with tenderness over the medial deltoid ligament is presumed to be ? |
|
Definition
| an unstable bimalleolar injury |
|
|
Term
| The relationships of the tibia, fibula, and talus are clearest in what x-ray view? |
|
Definition
| Mortise view (15 degree internally rotated AP) |
|
|
Term
|
Definition
| zone 2 fracture of the proximal diaphysis of the 5th metatarsal |
|
|
Term
| A 5th metatarsal zone 1 Fx is AKA? |
|
Definition
| Avulsion Fx (probably non-operative) |
|
|
Term
| A 5th metatarsal zone 2 Fx is AKA? |
|
Definition
| Jones Fx (may or may not need operation) |
|
|
Term
| A 5th metatarsal zone 3 Fx is AKA? |
|
Definition
| Stress Fx - NEED operation! (could cause nonunion/malunion) |
|
|
Term
|
Definition
| Fracture-dislocations of the midfoot (traumatic disruptions of the tarsometatarsal joints) |
|
|
Term
| What is the *critical* tarsometatarsal joint? |
|
Definition
|
|
Term
| What is the Tx for a displaced Lisfranc Fx? |
|
Definition
| Even a minimally displaced fracture-dislocation requires surgical reduction |
|
|
Term
| Fx's of the calcaneus or talus may also have an affect on what part of the body? |
|
Definition
| compression Fx of the lumbar spine |
|
|
Term
| A flattening of Bohler's angle indicates what? |
|
Definition
|
|
Term
|
Definition
| intersection b/t a straight line drawn along the upper surface of the tuber calacanei and a straight line connecting the highest points of the anterior and posterior joint surfaces of the calcaneus |
|
|
Term
| What is the normal angle range of Bohler's angle? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| MC site of arthritis in the foot |
|
Definition
| Hallux rigidus - MP joint of great toe |
|
|
Term
| Hallux rigidus is stiffness with dorsiflexion or plantar flexion? |
|
Definition
|
|
Term
| What's another name for a bunion? |
|
Definition
|
|
Term
|
Definition
| lateral deviation of great toe at MP joint |
|
|
Term
| What is the normal valgus angle at the MP joint of the great toe? |
|
Definition
|
|
Term
| What is normal great to MP extension and flexion angles? |
|
Definition
| e: 60-70 degrees; f: 30 degrees |
|
|
Term
| How is the MP range of motion affected with hallux valgus? |
|
Definition
| most patients have normal ROM |
|
|
Term
| What is the normal intermetatarsal (IM) angle of the great toe? |
|
Definition
|
|
Term
| What is Stage 1 of an ingrown toenail? |
|
Definition
|
|
Term
| What is Stage 2 of an ingrown toenail? |
|
Definition
| abscess - purulent or serous drainage (Most painful stage) |
|
|
Term
| What is Stage 3 of an ingrown toenail? |
|
Definition
| granulation - granulation tissue grows onto the nail plate, inhibiting drainage |
|
|
Term
|
Definition
| warm soaks, insert cotton under nail to lift it up until it grows out |
|
|
Term
|
Definition
| soaks, broad spectum oral antibiotics, partial nail excision |
|
|
Term
|
Definition
| partial or complete mail excision with or without ablation of the germinal matrix of the nail |
|
|
Term
| An avulsed nail requires how long to regrow? |
|
Definition
|
|
Term
|
Definition
| forefoot pain localized under one or more of the lesser metatarsals |
|
|
Term
| A persistent callus on the sole of the foot is called? |
|
Definition
| intractable plantar keratosis |
|
|
Term
| Activity-related pain is localized to the plantar aspect of the forefoot directly over the metatarsal heads |
|
Definition
|
|
Term
| What type of callus is tender with direct pressure? |
|
Definition
|
|
Term
| MC location of Morton neuroma |
|
Definition
| between 3rd and 4th toes (3rd web space) |
|
|
Term
| perineural fibrosis of the common digital nerve as it passes between the metatarsal heads |
|
Definition
|
|
Term
| MC presenting symptom of Morton Neuroma is? |
|
Definition
| Plantar pain in the forefoot |
|
|
Term
| PT states they feel they are "walking on a marble" or that there is "a wrinkle in my socks" |
|
Definition
|
|
Term
| What imaging studies are helpful for a Morton neuroma? |
|
Definition
|
|
Term
| What is the Tx of a Morton neuroma? |
|
Definition
| good shoes, metatarsal pads. Lidocaine w/ corticosteroid injection just proximal to the metatarsal heads can be both diagnostic and therapeutic |
|
|
Term
| Standard Tx of a Morton neuroma doesn't work, what's next? |
|
Definition
| surgical excision of the neuroma or a division of the transverse metatarsal ligament |
|
|
Term
| MC organisms causing toenail fungus infection? |
|
Definition
| Trichophyton rubrum and T mentagrophytes cause 90% |
|
|
Term
| The plantar fascia arises from the _________ and extends to ___________? |
|
Definition
| The plantar fascia arises from the medial tuberosity of the calcaneus and extends to the proximal phalanges of the toes |
|
|
Term
| MC cause of heel pain in adults |
|
Definition
|
|
Term
| Plantar fasciitis is usually associated with what foot type? |
|
Definition
| It is not associated with a particular foot type - but fat people get it more |
|
|
Term
| Before giving a corticosteroid for plantar fasciitis, what must you do first? |
|
Definition
| standing lateral x-ray - wait 8 weeks before giving a shot, though |
|
|
Term
| Initial Tx of plantar fasciitis includes? |
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Definition
| heel pad, home stretching, night splint, NSAIDS |
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Term
| What is a cool new Tx for plantar fasciitis (tech related)? |
|
Definition
| Extracorporal Shock Wave Therapy |
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Term
| What is a possible SE of giving a corticosteroid shot for plantar fasciiits? |
|
Definition
| fat pad necrosis or rupture of the plantar fascia (improper injection) |
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Term
| Superficial paring of a wart with a scalpel reveals ... ? |
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Definition
| punctate hemorrhage and a fibrillated texture |
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Term
| 4 DDX for posterior heel pain |
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Definition
| insertional Achilles tendinitis, retrocalcaneal bursitis, Haglund's syndrome, pump bump |
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Term
| Patients with a prominent process of the calcaneus initially develop a painful bursa that is irritated by shoe wear. This is called a ? |
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Definition
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Term
| How can you differentiate a retrocalcaneal bursitis from other posterior heel pain causes? |
|
Definition
| squeeze the bursa from side to side and just anterior to the Achilles tendon. Pain anterior to the Achilles tendon is a + |
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|
Term
| What is Haglund's syndrome? |
|
Definition
| a prominent process of the calcaneus impinging on the Achilles tendon |
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|
Term
| Primary cause of medial foot/ankle pain in the middle-aged patient is? |
|
Definition
| Posterior tibial tendon dysfunction |
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|
Term
| 55 year old lady with a flatfoot probably has? |
|
Definition
| Posterior tibial tendon dysfunction |
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Term
|
Definition
| Posterior tibial tendon dysfunction |
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|
Term
| When do you give a corticosteroid shot for Posterior tibial tendon dysfunction? |
|
Definition
| you don't! may weaken it more |
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|
Term
| Once a rigid flatfoot develops, the best Tx is now? |
|
Definition
|
|
Term
| What is one of the last joints to be involved in rheumatoid arthritis? |
|
Definition
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|
Term
| Most patients with severe arthritis of the hindfoot joints require what Tx? |
|
Definition
| triple arthrodesis: talocalcaneal, talonavicular, and calcaneocuboid joints |
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|
Term
| The sesamoid bones are embedded in what tendon? |
|
Definition
| in the flexor hallucis brevis tendon beneath the first metatarsal head (plantar surface) |
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|
Term
| Where will a PT with sesamoiditis feel pain? |
|
Definition
| under first metatarsal head; pain with dorsiflexion |
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|
Term
| How can you distinguish between bipartite or multipartite sesamoid bones and a sesamoid Fx? |
|
Definition
| normal variants: smooth margins; |
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|
Term
| Fx: sharp margins; you can compare to other foot also A J-shaped dancer's pad might help with what condition? |
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Definition
|
|
Term
| If a good shoe, boot, cast doesn't work for a Sesamoid Fx, what's next? |
|
Definition
| excision of the sesamoid bone |
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|
Term
| MC soft-tissues in the foot and ankle |
|
Definition
| ganglia and plantar fibromas |
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|
Term
| Ganglia on the foot are usually found where? |
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Definition
|
|
Term
| What is a plantar fibroma? |
|
Definition
| benign thickening of the plantar fascia |
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|
Term
| What condition is similar histologically to Dupuytren's disease - but on the foot? |
|
Definition
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|
Term
| Compare how a ganglion cyst would feel compared to a plantar fibroma. |
|
Definition
| GC: painless, movable, soft nodule; PF: firm mass(es) on plantar surface that may be painful and is part of the plantar facial band |
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|
Term
| A plantar fibroma is best treated with ... ? |
|
Definition
| shoe modifications and an orthotic device |
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|
Term
| MC site of stress fractures in the foot |
|
Definition
| metatarsals, especially 2nd |
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|
Term
| Tarsal tunnel syndrome is compression of which nerve? |
|
Definition
| posterior tibial nerve - or its branches posterior to the medial malleolus |
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|
Term
| Paresthesias (tingling) or dysthesias (burning) along the medial ankle may be? |
|
Definition
|
|
Term
| What's a good test for Tarsal tunnel syndrome? |
|
Definition
| Tinel sign - tap the posterior tibial nerve |
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|
Term
| The 3 deformities of the lesser toes: |
|
Definition
| hammer toes, claw toes, mallet toes |
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|
Term
|
Definition
| fixed extension of MP joint and flexion of PIP joint |
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|
Term
|
Definition
| Charcot-Marie-Tooth disease or RA |
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|
Term
|
Definition
| PIP flexion with no deformity of DIP or MP joints |
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|
Term
|
Definition
| DIP flexion with no deformity of PIP or MP joints |
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|
Term
| cavus foot associated with neurologic disorders makes you think of? |
|
Definition
| claw toe, hammertoe, mallet toe |
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|
Term
| Neurologic work-up may be indicated in patients with which lesser toe deformity? |
|
Definition
|
|
Term
|
Definition
| sprain of 1st MP joint that most commonly occurs with hyperextension but can occur with any forced ROM |
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|
Term
|
Definition
| stretch injury of capsule, mild symptoms, can still play sports |
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|
Term
|
Definition
| partial tear of plantar ligamentous complex of MP joint, swelling, ecchymosis, dec. ROM |
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|
Term
|
Definition
| complete tear of MP ligamentous complex, more swelling, bruising, less ROM - no sports or walking normal |
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|
Term
|
Definition
| protected weight bearing or immobilization for 1 to 2 weeks, with a 4 to 6 week period of rest from athletics |
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