Leg, Ankle, Foot DD

What is the typical age range for a patient presenting with Plantar Fasciitis?

20-60 years old

What is the characteristic mechanism of injury (MOI) for Plantar Fasciitis?

Gradual onset with no known direct cause

Which symptom onset pattern is classic for Plantar Fasciitis during weight-bearing?

Pain on the sole of the foot under the heel during weight-bearing, especially first thing in the morning.

What structural posture of the foot is commonly observed in Plantar Fasciitis?

Pronated foot or flattened arches

Which passive movement of the foot reproduces pain in Plantar Fasciitis?

Passive great toe extension

Where is point tenderness specifically located upon palpation in Plantar Fasciitis?

Plantar aspect of the heel

What primary special test is used to evaluate Plantar Fasciitis?

Windlass test

What is the typical age range for Achilles Tendinitis?

20-40 years old

What is the mechanism of injury (MOI) for Achilles Tendinitis?

Overuse

Which activities typically aggravate symptoms in Achilles Tendinitis?

Jumping and running on the posterior ankle

Where do you typically see swelling in patients with Achilles tendinitis

Posterior ankle

How are active and passive ankle dorsiflexion affected in Achilles Tendinitis?

Both are painful and limited

How does knee position influence passive dorsiflexion limitation in Achilles Tendinitis?

Passive dorsiflexion is limited with the knee in the extended position.

Which resisted isometric muscle testing produces pain in Achilles Tendinitis?

Resisted plantarflexion

What is the typical age range for Gastrocnemius strain?

20-40 years

What is the mechanism of injury (MOI) for a Gastrocnemius Strain?

Sudden overloading

Where is pain primarily localized in a Gastrocnemius strain?

Upper calf

Which active movement or test typically increases pain in a Gastrocnemius strain?

Heel raise

What gait deviation is typically observed in patients with a Gastrocnemius strain?

Antalgic gait

How are active and passive knee extension affected in Gastrocnemius strain?

Both are painful and limited

What motion will be painful with resistance for a Gastrocnemius strain

Plantarflexion

Where is tenderness specifically found on palpation in a Gastrocnemius strain?

Mid-to-upper calf area

What age range is typically seen for Posterior tibialis tendinitis

20-40 years

What mechanism of injury and foot posture are associated with Posterior Tibialis Tendinitis?

Overuse with a flat, pronated foot

Where is pain, tenderness and swelling primarily noted in Posterior Tibialis Tendinitis?

Medial ankle throughout the tendon

Which active and passive range of motion movements reproduce pain in Posterior Tibialis Tendinitis?

Active and passive plantarflexion and eversion

Which manual muscle test combination elicits pain in Posterior Tibialis Tendinitis?

Resisted inversion with a plantarflexed foot

What is the age range for those with Anterior Tibialis Tendinitis

15-45 years

What is the primary mechanism of injury for Anterior Tibialis Tendinitis?

Overuse

Which repetitive movement increases symptoms in Anterior Tibialis Tendinitis?

Repetitive dorsiflexion on anterior lower leg

Which combined active movement elicits pain in Anterior Tibialis Tendinitis?

Combined active plantarflexion and inversion

Which passive movement reproduces pain in Anterior Tibialis Tendinitis?

Passive plantarflexion

Which resisted movement causes pain in Anterior Tibialis Tendinitis?

Resisted dorsiflexion

What is the common age range for Medial Tibial Stress Syndrome (Shin Splints)?

15-30 years old

What is the primary mechanism of injury for Medial Tibial Stress Syndrome?

Overuse

Where is pain localized in Medial Tibial Stress Syndrome?

Anterior lower leg and posterior-medial lower leg

Which combined active movement causes pain in Medial Tibial Stress Syndrome?

Active combined plantarflexion and inversion

Which combined resisted movement causes pain in Medial Tibial Stress Syndrome?

Resisted plantarflexion and eversion

Where is point tenderness specifically elicited in Medial Tibial Stress Syndrome?

Posteromedial calf / tibia

What pathophysiological event defines Anterior Compartment Syndrome?

Increased pressure within the anterior compartment of the leg causing an ischemic condition.

What are three mechanisms of injury (MOIs) associated with Anterior Compartment Syndrome?

Direct trauma, muscle hypertrophy, or fracture

What three clinical complaints form the primary symptom presentation of Anterior Compartment Syndrome?

Severe cramping, diffuse pain, and tightness

How does rest affect pain in Anterior Compartment Syndrome?

Pain decreases with rest and increases with activity.

How does passive stretching affect pain in Anterior Compartment Syndrome?

Pain worsens with stretching.

What are the '6 Ps' to remember for compartment syndrome assessment?

Pain, Pallor, Paresis, Paresthesia, Pulselessness, Palpable tenderness

What is the definitive medical management required for acute Anterior Compartment Syndrome?

Emergency surgery (fasciotomy)

What is the typical age range for Morton's Neuroma?

40-60 years old

Which functional activity aggravates pain on the sole of the foot in Morton's Neuroma?

Weight-bearing activities

What typically can be seen in the foot in Morton’s Neuroma?

Pronated foot or flattened arch

Which passive toe movement reproduces pain in Morton's Neuroma?

Passive toe extension

Where is tenderness specifically localized during palpation in Morton's Neuroma?

Web space of the toes

What is the typical age range for Tarsal Tunnel Syndrome?

25-50 years old

What are common contributing factors or mechanisms of injury for Tarsal Tunnel Syndrome?

Posttraumatic onset, rapid weight gain, fluid retention, inflammatory conditions, abnormal foot/ankle biomechanics, or valgus foot deformity.

Which nerve's distribution is affected in Tarsal Tunnel Syndrome?

Posterior tibial nerve

Where do symptoms radiate in Tarsal Tunnel Syndrome?

Medial malleolus, up the leg, or down into the medial arch, plantar surface of the foot, and toes.

Which biomechanical action exacerbates symptoms during walking or running in Tarsal Tunnel Syndrome?

Excessive pronation

What can you expect to see in the foot in Tarsal tunnel syndrome

Pronated foot and pes planus

Which passive movement combination is painful in Tarsal Tunnel Syndrome?

Passive plantarflexion and eversion

Which resisted muscle action causes pain in Tarsal Tunnel Syndrome?

Resisted toe flexion

Which special test is positive in Tarsal Tunnel Syndrome?

Tinel's sign

What age do you typically see metatarsal stress fracture

15-45 years old

What is the primary mechanism of injury (MOI) for a Metatarsal Stress Fracture?

Overuse

Which specific activity pattern increases symptoms in a Metatarsal Stress Fracture?

Weight-bearing activities on the forefoot

Which metatarsal bone shaft is specifically noted as a common site for stress fractures?

2nd metatarsal shaft

What diagnostic tools/tests are used to evaluate a Metatarsal Stress Fracture?

Palpation, ultrasound, tuning fork, bone scan, MRI, and CT scan.

What age do you typically see Midfoot sprains

15-40 years old

What mechanisms of injury cause a Midfoot Sprain?

High-impact landing or foot twisted when in a fixed position.

Which specific weight-bearing action increases symptoms in a Midfoot Sprain?

Walking on toes

Which passive clinical technique reproduces pain in a Midfoot Sprain?

Passive midfoot pronation and supination while the hindfoot is stabilized.

Which radiographic views are required when assessing a Midfoot Sprain?

Weightbearing lateral and anterior-posterior radiographs

What is Sever's Disease (Calcaneal Apophysitis)?

A traction apophysitis at the insertion of the Achilles tendon on the calcaneus.

What is the typical age range for a patient with Sever's Disease?

8-13 years old

What contributing mechanical factors increase the risk of Sever's Disease?

Foot pronation, tight gastrocnemius-soleus complex, and jumping or landing from a height.

Where is pain localized in Sever's Disease, and how does it react to rest?

Pain is over the posterior-inferior heel; it increases with weight-bearing and resolves with rest.

Which joint motion restriction is characteristic of Sever's Disease?

Limited dorsiflexion and stiffness

Which physical examination special test evaluates Sever's Disease?

Squeeze test (of the calcaneus)

What imaging modality is typically ordered to confirm Sever's Disease?

X-ray

What defines Forefoot Varus?

Inversion of the forefoot with the subtalar joint in neutral.

What defines Forefoot Valgus?

Eversion of the forefoot with the subtalar joint in neutral.