Foot & Ankle Examination Mazyad Alotaibi

Subjective Age Occupation & Sport – sports, shoes, dominant foot Site - localised Spread - little Onset – overuse, trauma, insidious Duration – recent, longstanding, intermittent Behaviour – agg/ ease Symptoms – clicking, crepitus, locking, swelling, p+ns PMSH

Observation Gait Posture Deformity Colour Wasting Swelling Site of pain State at rest

Palpation Heat Swelling Synovial Thickening Pulses

Ankle Joint Capsular pattern = more loss of plantar flex Pain, range and end feel Passive plantar flex Passive dorsi-flex (knee flexed)

Ankle Joint Ligaments Passive plantar flexion and inversion Stresses lateral ligaments Passive plantar flexion and eversion Stresses deltoid ligament

Muscles Pain and power Resisted dorsi-flexion Resisted plantar flexion Resisted eversion Resisted inversion

Additional Tests Instability test – draw test Differentiation of ligaments: Anterior talo-fibular – plantar flex with inv Calcaneo-fibular – ankle in DF with varus of heel Calcaneo-cuboid – midtarsal inv with add Proprioception tests