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Ankle Pathologies
Ankle and Low Leg Pathologies
Question | Answer |
---|---|
Anterior Compartment Syndrome | Resulting from increased pressure within the anterior compartment and threatens the integrity of the leg, foot, and toes. |
Anterior Compartment Syndrome Identifying Information 1/2 | Anterior compartment may appear shiny and swollen. Possible discoloration of the dorsum of the foot. Involved compartment is hard and edematous to the touch. Painful to touch. AROM: Decreased DF and toe extension. MMT: not indicated. |
Anterior Compartment Syndrome Identifying Information 2/2 | PROM: Pain during passive motion Special tests: No clinical tests for this condition. Anterior compartment syndrom is confirmed by measuring the intracompartmental pressure. |
Anterior Compartment Syndrome Differential Diagnosis | Tibial Fracture and fibular fracture |
Subluxating Peroneal Tendons | Subluxation of the peroneal tendon |
Subluxating Peroneal Tendons Identifying Information 1/2 | Swelling and ecchymosis may be isolated behind the lateral malleolus. Tendons may be seen to sublux during resisted eversion. Tenderness behind the lateral malleolus, over peroneal tendons, and possibly over the inferior peroneal retinaculum. |
Subluxating Peroneal Tendons Identifying Information 2/2 | AROM: Peroneal tendon may be seen, felt, or heard as it subluxates while the foot and ankle move from plantarflexion and inversion to dorsiflexion and eversion and back. MMT: Peroneals: Symptoms reproduced PROM: No significant findings. Special Tests: N/ |
Subluxating Peroneal Tendons Differential Diagnosis | Longitudinal tear of the tendon, os peroneum syndrome, lateral ankle sprain, fibular fracture, calcaneal process fracture, talar fracture, osteochondritis dessicans. |
Achilles Tendon Rupture | Rupture of the Achilles Tendon |
Achilles Tendon Rupture Identifying Information 1/2 | Visible defect in the Achilles tendon. Rapid swelling, discoloration. PT unable to bear weight. Palpable defect. Pain along the tendon and lower gastrocnemius-soleus muscle group. AROM: possible plantarflexion still present. MMT: weak or absent. |
Achilles Tendon Rupture Identifying Information 2/2 | PROM: pain during DF, empty end-feel may be present. Special Tests: Thompson test |
Achilles Tendon Rupture Differential Diagnosis | Posterior tibial tendon rupture, plantaris tendon rupture, tricps surae strain, achilles tendinopathy, deep vein thrombosis. |
Os Trigonum Syndrome | Formed when Stieda's process separates from the talus |
Os Trigonum Syndrome Identifying Information 1/2 | Swelling anteromedial and anterolateral to the achilles tendon. pain elicited when palpating the posterior talus, anterior to the achilles tendon. AROM: pain w/ plantarflexion. MMT: Gastrocnemius and soleus testing may reproduce symptoms. |
Os Trigonum Syndrome Identifying Information 2/2 | PROM: Pain w/ forced plantarflexion, compressing the structures. Pain with forced dorsiflexion, stretching the structures. Special Tests: Not Applicable |
Os Trigonum Syndrome Differential Diagnosis | Achilles tendinopathy, tibialis posterior tendinopathy, flexor hallucis longus tendinopathy, peroneal tendon subluxation, lateral ankle instability, arthritis, tarsal tunnel syndrom, tarsal coalition, talus fracture |
Ankle and Leg Fractures | Fracture of the one of the tarsals or the tibia or fibula. |
Ankle and Leg Fractures Identifying Information 1/2 | Possible visible deformity, swelling and ecchymosis, point tenderness, possible crepitus, possible palpable deformity. AROM: assess willingness to move knee and ankle. MMT: Don't perform with suspected fx. PROM: Don't perform with suspected fx. |
Ankle and Leg Fractures Identifying Information 2/2 | Special Tests: Bump Test, Squeeze test (DO NOT perform in the presence of an obvious fracture) |
Ankle and Leg Fractures Differential Diagnosis | Lateral ankle sprain, talocrural joint dislocation, subtalar dislocation, deltoid ligament sprain, compartment syndrome. |
Syndesmotic Ankle Sprains | Also known as a high ankle sprain. Injury to the tibiofibular syndesmosis. |
Syndesmotic Ankle Sprain Identifying Information 1/2 | Swelling present over the distal tibiofibular syndesmosis, but is less prominent and wide spread as compared to lateral ankle sprains. Pain over the distal tibiofibular syndesmosis, pain over the anterior and posterior tibiofibular ligaments |
Syndesmotic Ankle Sprain Identifying Information 2/2 | AROM: Motion limited and pain elicited. MMT: Anterior tibialis, posterior tibialis may be weak and painful. PROM: limited with pain. Special Tests: External rotation test, dorsiflexion-compression test, squeeze test. |
Syndesmotic Ankle Sprain Differential Diagnosis | Lateral ankle sprain, fibular fracture, deltoid sprain |