Ankle pain Pain An unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons. Pain: Types and Pathways accounts for up to 20% of cases of musculoskeletal complaints in outpatient clinics. The most common etiologies of foot Foot The foot is the terminal portion of the lower limb, whose primary function is to bear weight and facilitate locomotion. The foot comprises 26 bones, including the tarsal bones, metatarsal bones, and phalanges. The bones of the foot form longitudinal and transverse arches and are supported by various muscles, ligaments, and tendons. Foot: Anatomy and ankle pain Pain An unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons. Pain: Types and Pathways can be categorized into arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis, trauma, sprains, and systemic causes. The diagnosis is clinical with imaging and/or laboratory studies to confirm the suspected diagnosis. Management involves rest, ice packs, compression Compression Blunt Chest Trauma, elevation, and nonsteroidal anti-inflammatory drugs ( NSAIDs NSAIDS Primary vs Secondary Headaches). Surgical repair is rarely needed.
Last updated: 8 Jan, 2021
Epidemiology
Foot Foot The foot is the terminal portion of the lower limb, whose primary function is to bear weight and facilitate locomotion. The foot comprises 26 bones, including the tarsal bones, metatarsal bones, and phalanges. The bones of the foot form longitudinal and transverse arches and are supported by various muscles, ligaments, and tendons. Foot: Anatomy pain Pain An unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons. Pain: Types and Pathways is more common among people who wear uncomfortable shoes (usually women).
Classification
History
Physical examination
Ottawa ankle and foot Foot The foot is the terminal portion of the lower limb, whose primary function is to bear weight and facilitate locomotion. The foot comprises 26 bones, including the tarsal bones, metatarsal bones, and phalanges. The bones of the foot form longitudinal and transverse arches and are supported by various muscles, ligaments, and tendons. Foot: Anatomy rules:
Ottawa ankle and foot Foot The foot is the terminal portion of the lower limb, whose primary function is to bear weight and facilitate locomotion. The foot comprises 26 bones, including the tarsal bones, metatarsal bones, and phalanges. The bones of the foot form longitudinal and transverse arches and are supported by various muscles, ligaments, and tendons. Foot: Anatomy rules
Image by Lecturio.The etiology of ankle or foot Foot The foot is the terminal portion of the lower limb, whose primary function is to bear weight and facilitate locomotion. The foot comprises 26 bones, including the tarsal bones, metatarsal bones, and phalanges. The bones of the foot form longitudinal and transverse arches and are supported by various muscles, ligaments, and tendons. Foot: Anatomy pain Pain An unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons. Pain: Types and Pathways can be determined from the anatomical location of the maximum point of pain Pain An unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons. Pain: Types and Pathways or tenderness.
Location | Condition | Features |
---|---|---|
Lateral aspect | Ankle sprain (acute pain Pain An unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons. Pain: Types and Pathways) |
|
Medial aspect |
|
|
Posterior aspect | Achilles tendinitis Achilles Tendinitis Examination of the Lower Limbs (acute pain Pain An unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons. Pain: Types and Pathways) |
|
Variable Variable Variables represent information about something that can change. The design of the measurement scales, or of the methods for obtaining information, will determine the data gathered and the characteristics of that data. As a result, a variable can be qualitative or quantitative, and may be further classified into subgroups. Types of Variables locations | Infectious Infectious Febrile Infant and inflammatory conditions |
|
Location | Condition | Features |
---|---|---|
Forefoot (toes + distal metatarsals) | Bunions (hallux valgus) |
|
Ingrown toenails |
|
|
Morton neuroma |
|
|
Corns and calluses |
|
|
Plantar warts Warts Benign epidermal proliferations or tumors; some are viral in origin. Female Genitourinary Examination |
|
|
Metatarsal stress fractures Stress Fractures Fractures due to the strain caused by repetitive exercise. They are thought to arise from a combination of muscle fatigue and bone failure, and occur in situations where bone remodeling predominates over repair. The most common sites of stress fractures are the metatarsus, fibula, tibia, and femoral neck. Chronic Apophyseal Injury |
|
|
Midfoot ( tarsal bones Tarsal Bones The seven bones which form the tarsus – namely, calcaneus; talus; cuboid, navicular, and the internal, middle, and external cuneiforms. Foot: Anatomy, arches, and ligaments) | Osteoarthritis Osteoarthritis Osteoarthritis (OA) is the most common form of arthritis, and is due to cartilage destruction and changes of the subchondral bone. The risk of developing this disorder increases with age, obesity, and repetitive joint use or trauma. Patients develop gradual joint pain, stiffness lasting < 30 minutes, and decreased range of motion. Osteoarthritis |
|
High-arched feet ( pes PES Removal of plasma and replacement with various fluids, e.g., fresh frozen plasma, plasma protein fractions (ppf), albumin preparations, dextran solutions, saline. Used in treatment of autoimmune diseases, immune complex diseases, diseases of excess plasma factors, and other conditions. Thrombotic Thrombocytopenic Purpura cavus) and flat feet ( pes PES Removal of plasma and replacement with various fluids, e.g., fresh frozen plasma, plasma protein fractions (ppf), albumin preparations, dextran solutions, saline. Used in treatment of autoimmune diseases, immune complex diseases, diseases of excess plasma factors, and other conditions. Thrombotic Thrombocytopenic Purpura planus) |
|
|
Navicular Navicular Foot: Anatomy stress fracture Fracture A fracture is a disruption of the cortex of any bone and periosteum and is commonly due to mechanical stress after an injury or accident. Open fractures due to trauma can be a medical emergency. Fractures are frequently associated with automobile accidents, workplace injuries, and trauma. Overview of Bone Fractures |
|
|
Hindfoot ( talus Talus The second largest of the tarsal bones. It articulates with the tibia and fibula to form the ankle joint. Ankle Joint: Anatomy + calcaneus Calcaneus The largest of the tarsal bones which is situated at the lower and back part of the foot, forming the heel. Foot: Anatomy) | Plantar fasciitis |
|
Tarsal tunnel syndrome |
|
|
Calcaneal and talar stress fractures Stress Fractures Fractures due to the strain caused by repetitive exercise. They are thought to arise from a combination of muscle fatigue and bone failure, and occur in situations where bone remodeling predominates over repair. The most common sites of stress fractures are the metatarsus, fibula, tibia, and femoral neck. Chronic Apophyseal Injury |
|
|
Calcaneal apophysitis Apophysitis Osgood-Schlatter Disease (Sever’s disease) |
|
Diagnostic workup:
X-ray X-ray Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source. Pulmonary Function Tests of the foot Foot The foot is the terminal portion of the lower limb, whose primary function is to bear weight and facilitate locomotion. The foot comprises 26 bones, including the tarsal bones, metatarsal bones, and phalanges. The bones of the foot form longitudinal and transverse arches and are supported by various muscles, ligaments, and tendons. Foot: Anatomy of an 11-year-old boy, showing sclerosis Sclerosis A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. Wilms Tumor and fragmentation Fragmentation Chronic Apophyseal Injury of the calcaneal apophysis. However, X-rays X-rays X-rays are high-energy particles of electromagnetic radiation used in the medical field for the generation of anatomical images. X-rays are projected through the body of a patient and onto a film, and this technique is called conventional or projectional radiography. X-rays have poor sensitivity Sensitivity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Blotting Techniques and specificity Specificity Specificity is the probability of correctly determining the absence of a condition. Immunoassays for Sever’s disease so diagnosis is usually made clinically.
Image: “ Sclerosis Sclerosis A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. Wilms Tumor and fragmentation Fragmentation Chronic Apophyseal Injury of the calcaneal apophysis” by Mikael Häggström. License: CC0 1.0The following are common conditions associated with ankle and foot Foot The foot is the terminal portion of the lower limb, whose primary function is to bear weight and facilitate locomotion. The foot comprises 26 bones, including the tarsal bones, metatarsal bones, and phalanges. The bones of the foot form longitudinal and transverse arches and are supported by various muscles, ligaments, and tendons. Foot: Anatomy pain Pain An unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons. Pain: Types and Pathways: