Clinical Pattern Recognition: Ankle & Foot

Practice vocabulary terms for ankle and foot clinical pattern recognition, including ICF classifications, definitions, and red flag diagnostic criteria.

Tibialis anterior tendonitis/Shin splints/Medial tibial stress syndrome

ICF: Muscle power deficits; an exercise “overuse” related pain of the anterior or medial tibia caused by irritation of the tendons, muscle or bone.

Plantar fasciitis

ICF: Ankle stability and movement coordination impairments; results when the plantar aponeurosis becomes irritated and inflamed; can cause pain at the attachment on the medial tubercle of the calcaneus.

Posterior tibialis tendonitis

ICF: Muscle power deficits; an acute, painful inflammation of the tibialis posterior tendon.

Achilles tendonitis

ICF: Muscle power deficits; an acute, painful inflammation of the achilles tendon.

High ankle sprain

ICF: Ankle stability and movement coordination impairments; an acute, painful inflammation of the tibiofibular interosseous membrane.

Ankle sprain

ICF: Ankle stability and movement coordination impairments; an acute, painful inflammation of the lateral ankle ligaments, specifically the anterior talofibular or calcaneofibular ligament.

Ankle osteoarthritis/capsulitis

ICF: Ankle/Foot mobility deficits; a progressive disorder caused by gradual loss of cartilage, resulting in bony spurs and cysts at joint margins, leading to stiffness and pain.

Tarsal tunnel syndrome

ICF: Ankle and foot radiating pain; a neuropathy and painful foot condition resulting from tibial nerve compression.

Plantar neuropathy

ICF: Ankle and foot radiating pain; entrapment of the plantar nerves in the hind or midfoot, often related to repetitive compression and weight bearing.

Morton’s neuroma

ICF: Ankle and foot radiating pain; thickening of the fibrous tissue surrounding a sensory digital nerve, usually at the base of the $2^{nd}$ and $3^{rd}$ or $3^{rd}$ and $4^{th}$ toes.

Hallux valgus

ICF: Great toe mobility deficits; a condition where the big toe (hallux) is bent outward (valgus) at the MTP joint so it overlaps the $2^{nd}$ toe.

Hallux rigidus

ICF: Great toe mobility deficits; a degenerative arthritic condition that affects the MTP joint of the big toe.

Cellulitis

A common potentially serious bacterial skin infection (ICD $10$: $682.6$) characterized by pain, swelling, warmth, and advancing irregular margins of erythema or reddish streaks.

Compartment Syndrome

A painful condition (ICD $10$: $958.9$) related to rapid increase in pressure within muscles leading to loss of blood flow; symptoms include severe pain intensified with stretch, paresthesia, paresis, and pulselessness.

Deep Vein Thrombosis

A blood clot in the deep veins (ICD $10$: $453.40$); findings include calf pain, edema, and tenderness intensified by standing or walking and relieved by rest and elevation.

Peripheral Arterial Occlusive Disease

Hardening and narrowing of the arteries (ICD $10$: $443.9$); findings include cool extremity, prolonged capillary refill time ($> 2\text{ sec}$), and an ankle brachial index $< 0.90$.

Fractures

Loss of bone continuity (ICD $10$: $823.0$) due to trauma or overuse; findings include joint effusion, hemarthrosis, bruising, and unwillingness to bear weight.

Septic Arthritis

An intensely painful infection in a joint (ICD $10$: $711.00$) causing constant aching/throbbing pain, joint swelling, tenderness, warmth, and elevated body temperature.