ankle & foot exam

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EXAMINATION OF ANKLE AND FOOTEXAMINATION OF ANKLE AND FOOT

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EXAMINATION OF ANKLE AND FOOTEXAMINATION OF ANKLE AND FOOT

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EXAMINATION OF ANKLE AND FOOTEXAMINATION OF ANKLE AND FOOT

INSPECTION (LOOK)

Expose the whole lower leg and foot.

Look at the patient standing (and then sitting).

Examine the soles of the patient's shoes for signs of asymmetrical wear

Look for side to side asymmetry or abnormal contact w/ the ground

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EXAMINATION OF ANKLE AND FOOTEXAMINATION OF ANKLE AND FOOT

INSPECTION - LOOK (GAIT)

High stepping gait (foot drop, equinovarus)

Antalgic gait (ankle, hindfoot or midfoot pain)

Short propulsive phase (forefoot pain)

Attitude & Deformity

Sinus, scars

Wasting, Swellings

Skin condition

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EXAMINATION OF ANKLE AND FOOTEXAMINATION OF ANKLE AND FOOT

INSPECTION - LOOK

Alignment (especially genu valgus with flat feet)

Shapes and positions of the feet. (Equinus, Calcaneus)

Medial arch - obliterated in pes planus, exaggerated in pes cavus

Hind foot - (from behind) - varus (pes cavus) or valgus (pes planus). stand on tiptoes and see if deformity corrects (= mobile subtalar joint). 'Too many toes' sign . This occurs in pes planus, splayed forefoot.

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EXAMINATION OF ANKLE AND FOOTEXAMINATION OF ANKLE AND FOOT

INSPECTION - LOOK (SHAPE)

Neutral - no overall deformity

Flat foot - heel valgus, low arch

Cavus foot - typically with a plantar flexed first ray, high arch, hindfoot is in varus Skewfoot - hindfoot valgus and forefoot adduction.

Metatarsus adductus - neutral hindfoot and adduction of the metatarsus

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EXAMINATION OF ANKLE AND FOOTEXAMINATION OF ANKLE AND FOOT

PALPATION (FEEL)

Tenderness & Temperature ANKLETenderness over the - the anterior joint line - the lateral gutter and lateral ligaments - the syndesmosis - the posterior joint line - the medial ligament complex - the medial gutter

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EXAMINATION OF ANKLE AND FOOTEXAMINATION OF ANKLE AND FOOT

PALPATION (FEEL)

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EXAMINATION OF ANKLE AND FOOTEXAMINATION OF ANKLE AND FOOT

PALPATION (FEEL)

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EXAMINATION OF ANKLE AND FOOTEXAMINATION OF ANKLE AND FOOT

MOVEMENTCompare both sides

ANKLE

Active - Dorsiflexion - PlantarflexionPassive - Dorsiflexion Plantarflexion (Put one hand on the heel with the same forearm supporting the foot. The other hand supports the tibia. Dorsiflex the ankle by lifting the forearm under the foot.)

Active/Passive

Range of movement

Painful/ painless

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EXAMINATION OF ANKLE AND FOOTEXAMINATION OF ANKLE AND FOOT

MOVEMENT: Dorsi flexion Plantar flexion

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EXAMINATION OF ANKLE AND FOOTEXAMINATION OF ANKLE AND FOOT

SPECIAL TESTS:

ANTERIOR INSTABILITY (Anterior drawer test)

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EXAMINATION OF ANKLE AND FOOTEXAMINATION OF ANKLE AND FOOT

MUSCLE TESTING:

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EXAMINATION OF ANKLE AND FOOTEXAMINATION OF ANKLE AND FOOT

ACHILLES TENDON TEST (Simmonds / Thompson)

Lie the patient prone and squeeze the calf to elicit movement at the ankle = intact TA.

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EXAMINATION OF ANKLE AND FOOTEXAMINATION OF ANKLE AND FOOT

BLOCK TEST:

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EXAMINATION OF ANKLE AND FOOTEXAMINATION OF ANKLE AND FOOT

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EXAMINATION OF ANKLE AND FOOTEXAMINATION OF ANKLE AND FOOT

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EXAMINATION OF ANKLE AND FOOTEXAMINATION OF ANKLE AND FOOT