EXAMINATION OF ANKLE AND FOOT

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EXAMINATION OF ANKLE AND FOOT

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EXAMINATION 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 FOOT

INSPECTION - LOOK (GAIT)
High stepping gait
(foot drop, equinovarus)
Antalgic gait
(ankle, hindfoot or midfoot pain)

Attitude & Deformity

Skin condition

Sinus, scars

Short propulsive phase

(forefoot pain)
Wasting, Swellings
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EXAMINATION 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 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 FOOT

PALPATION (FEEL)
Tenderness & Temperature
ANKLE
Tenderness 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 FOOT

PALPATION (FEEL)

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EXAMINATION OF ANKLE AND FOOT

PALPATION (FEEL)

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EXAMINATION OF ANKLE AND FOOT

MOVEMENT
Compare both sides

Range of movemen
Active/Passive

ANKLE
Active - Dorsiflexion
- Plantarflexion
Passive Dorsiflexion
Plantarflexion

Painful/ painless

(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.)
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EXAMINATION OF ANKLE AND FOOT

MOVEMENT:
Dorsi flexion
Plantar flexion

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EXAMINATION OF ANKLE AND FOOT

SPECIAL TESTS:
ANTERIOR INSTABILITY (Anterior drawer test)

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EXAMINATION OF ANKLE AND FOOT

MUSCLE TESTING:

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EXAMINATION 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 FOOT

BLOCK TEST:

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EXAMINATION OF ANKLE AND FOOT

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EXAMINATION OF ANKLE AND FOOT

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EXAMINATION OF ANKLE AND FOOT

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