Musculo-skeletal > Foot Problems > Flashcards

Foot Problems Flashcards

(40 cards)

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1
Q

What is the aetiology of hallux valgus (bunions)?

A
  • Genetic
  • Foot wear
  • Female > Male
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2
Q

What are the symptoms of hallux valgus?

A
  • Pressure symptoms from shoe wear
  • Pain from crossing over of toes
  • Metatarsalgia
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3
Q

Describe the pathogenesis of hallux valgus

A
  • Lateral angulation of the great toe
  • Tendon pull realigned to lateral of centre of rotation of toe
  • Increased pull worsens the deformity
  • Sesamoid bones sublux - less weight foes through the big toe
  • Abnormalities of the lesser toes begin to occur
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4
Q

How can hallux valgus be diagnosed?

A
  • Clinical

- XR

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5
Q

How can hallux valgus be managed?

A
  • Shoe wear modification
  • Orthotics
  • Activity modification
  • Analgesia
  • Operative: release lateral soft tissues and osteotomy
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6
Q

What is hallux rigidus?

A

Osteoarthritis of the 1st MTP joint (pain and limitation of movement

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7
Q

How is hallux rigidus diagnosed?

A
  • Clinical

- Radiographs

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8
Q

How can hallux rigidus?

A
  • Activity modification
  • Shoe wear with rigid sole
  • Analgesia
  • Surgery: cheilectomy, arthrodesis and arthroplasty
  • 1st MTPJ fusion is gold standard
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9
Q

Name three lesser toe deformities

A
  • Hammer toe
  • Claw toe
  • Mallet toe
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10
Q

What is the aetiology of lesser toe deformities?

A
  • Imbalance between flexors and extensors
  • Shoe wear
  • Neurological
  • RA
  • Idiopathic
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11
Q

What is the presentation of lesser toe deformities?

A
  • Deformity
  • Pain from dorsum
  • Pain from plantar side
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12
Q

What are the management options for lesser toe deformities?

A
  • Activity modification
  • Shoe wear modifications
  • Orthotic insoles
  • Operative: flexor to extensor transfer, fusion of IPJ, release of MPJ and shortening osteotomy of metatarsal
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13
Q

What is the aetiology of Morton’s neuroma?

A
  • Mechanical degenerative neuropathy
  • Females aged 40-60
  • Associated with wearing high heeled shoes
  • Common digital nerve relatively tethered to one metatarsal and movement in the adjacent metatarsal causing mechanical shear
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14
Q

What are the symptoms of Morton’s neuroma?

A
  • Typically affects 3rd followed by 2nd webspace/toes
  • Neuralgic burning pain into toes
  • Intermittent
  • Altered sensation in the webspace
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15
Q

How is Morton’s neruoma diagnosed?

A
  • Clinical
  • Mulder’s click
  • USS/MRI
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16
Q

How can Moton’s neuroma be managed?

A
  • Injection for small lesions

- Excision of the lesion including a section of normal nerve

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17
Q

What are the management options for rheumatoid forefoot?

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A
  • Shoewear/orthotics/activity etc.
  • 1st MTPJ arthrodesis
  • 2-5th toe excision arthroplasty
18
Q

What are the causes of dorsal foot ganglia and how is it treated?

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A
  • Cause: idiopathic, underlying arthritis and underlying tendon pathology
  • Pain from pressure from foot wear or pain from underlying problem
19
Q

How can dorsal foot ganglia be treated?

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A
  • Aspiration
  • Excision
  • Hit it with something heavy
20
Q

What are the treatment options for midfoot arthritis?

Study These Flashcards
A
  • Activity/shoewear/orthotics etc.
  • Injections
  • Fusion
21
Q

What is plantar fibromatosis and how does it present?

Study These Flashcards
A
  • Dupuytren’s of the foot

- Usually asymptomatic unless very large or on weight bearing area

22
Q

How can plantar fibromatosis be treated?

Study These Flashcards
A
  • Avoid pressure: footwear and orthotics
  • Excision
  • Rafiotherapy
  • Combination of radiotherapy and surgery
23
Q

How does Achilles tendinopathy present?

Study These Flashcards
A
  • Insertion or non insertional/ mid substance tendinopathy
  • Bursitis (retrocalcaneal or superficial calcaneal)
  • Paratendinopathy
24
Q

What is the aetiology of achilles tendinopathy?

Study These Flashcards
A
  • Para is commonest in athletic populations aged 30-40

- Tendinopathy: over 40, obesity, steroids and diabetes

25
What are the symptoms of achilles tendinopathy?
- Pain during or following exercise - Recurrent episodes - Difficulty fitting shoes - Rupture
26
How can achilles tendinopathy be diagnosed?
- Clinical - USS - MRI
27
How can achilles tendinopathy be treated?
- Activity modification - Weight loss - Shoe wear modification - Physio - Shockwave treatment - Immobilisation - Gastrocnemius recession - Release and debridement of the tendon
28
What is plantar fasciosis/fasciitis?
Chronic degenerative change, fibroblast hypertrophy, absence of inflammatory cells, disorganised and dysfunctional blood vessels and collagen
29
What is the aetiology of plantar fasciitis?
- Athletes with high intensity or rapid increase in training - Running with poorly padded shoes or on hard surfaces - Obesity - Occupations involving prolonged standing - Lower limb rotational deformities - Tight gastro-soleus complex
30
What are the symptoms of plantar fasciitis?
- Pain first thing in the morning - Pain on weight bearing after rest - Pain at the origin of plantar fascia - Frequently lasts 2 yrs or more
31
What investigations can be used to diagnose plantar fasciitis?
- XR - USS - MRI
32
What are the management options for plantar fasciitis?
- Rest, chainge training - Stretching - ICE - NSAIDs - Orthoses - Physio - Weight loss - Injections (steroid) - Night splinting
33
What are the management options for ankle arthritis?
- Weight loss/activity modification/physio/steroid injections - Arthroscopic anterior debridement - Arthrodesis - Joint replacement
34
What are the features of tibialis posterior tendon dysfunction?
- Acquired adult flat foot planovalgus - Diagnosed by double and single heel raise and MRI - Medial or lateral pain
35
How can tibialis posterior tendon dysfunction be treated?
- Orthoses | - Surgery: reconstruction or triple fusion (subtalar, talonavicular and calcaneocuboid)
36
How can a diabetic foot ulcer be treated?
- Prevention - Modify causative factors: - diabetic control, smoking etc. - Vascular supply, external/ internal pressure, infection and nutrition - Surgical: improve vascular supply, debride ulcers, correct any deformity and amputation
37
What are the causes of charcot neuroarthropathy?
- Any neuropathy (diabetic most common) | - Historically associated with syphilis
38
Describe the pathophysiology of charcot neuroarthropathy
- Neurotraumatic: lack of proprioception and protective pain sensation - Neurovascular: abnormal autonomic nervous system results in increased vascular supply and bone resorption - 3 Stages: fragmentation, coalaescence and remodelling
39
Which investigations can help diagnose charcot neuroarthropathy?
- XR | - MRI
40
How can Charcot neuroarthropathy be managed?
- Prevention - Immobilisation/non weight bearing - Correct deformity
Musculo-skeletal
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